THE DETECTION 
O F 
CRIMINAL ABORTION, 
AND A 
STUDY OF FCETICIDAL DRUGS. 
B Y 
ELY VAJS DE WARKER, M. D., 
CORRESPONDING MEMBER OF THE GYNECOLOGICAL SOCIETY OF BOSTON. 
SYRACUSE, N. Y. 
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Publisher and Bookseller, 
Boston, Mass. THE DETECTION 
O P 
CRIMINAL ABORTION, 
A_ND A 
STUDY OF FCETICIDAL DRUGS. 
ELY VAN DE WARKER, M. D., 
BY 
SYRACUSE, N. Y. 
CORRESPONDING MEMBER OF THE GYNECOLOGICAL SOCIETY OF BOSTON. 
BOSTON: 
JAMES CAMPBELL, PUBLISHER, 
18 Tremont St., Museum Building. 
1872. Entered according to Act of Congress, in the year 1872, by 
JAMES CAMPBELL, 
In the office of the Librarian of Congress, at Washington. 
Rockwell & Churchill, Printers and Stereotypers, 
122 Washington Street, Boston. fo 
HOEATIO E. STOEEE, M.D., LL. B. 
AS AN HUMBLE EVIDENCE OF ADMIRATION FOR HIS GENIUS; 
AS A 
BLIGHT RETURN FOR HIS BRAVE WORDS TO THE MEN AND WOMEN OF 
HIS COUNTRY UPON THIS 
ORXInSJB O F THE PERIOD, 
AND AS A 
GRATEFUL CONSIDERATION FOR EIS CORDIAL RECOGNITION OF TEE 
LABORS OF 
2T fj t 3 tt t fj 0 t«' PREFACE. 
If this monograph is received in the same spirit in which it is 
written, the author will be sufficiently repaid. 
The greater portion — except one chapter, that on “ Other Points in 
the Diagnosis of Instrumental Abortion,” which is added entire — 
was published in the Journal of the Gynaecological Society of Boston, 
as a serial. To the monograph, as so published, new matter has been 
•added in many places. Those readers who are familiar with it in the 
pages of the Gynaecological Journal will at once recognize the value 
of these additions. 
The design of the papers is the detection of the crime in the vast 
number of cases of which the law takes no cognizance, but with 
which the physician is brought in continual contact. It also attempts 
to render evident the symptoms following the criminal use of abor- 
tifacient drugs. 
It is not supposed that the physician is to turn detective or in- 
former, but surely this great evil cannot be too carefully or closely 
studied. 
The author believes he has followed a path which was compara- 
tively unexplored, and he hopes the new facts he has been able to 
present will tend to make more easy of recognition this crime of the 
period. 
The author takes pleasure in acknowledging the obligations he is  PREFACE. 
under to his accomplished friend, Dr. John Van Duyn, of this city, 
for his assistance in many of the experiments. 
Also, to Mr. H. E. Eaton, Druggist, for the use of chemicals, and 
facilities for experiment. 
E. V. D. W. 
Syracuse, November 13, 1871. THE 
DETECTION OF CRIMINAL ABORTION. 
CHAPTER I. 
INSTRUMENTAL ABORTION. 
The recollection of many attempts, occurring to my- 
self and others, to conceal from the medical attendant 
the fact that a criminal abortion is in progress, inspires 
this paper. It is appropriately a paper of the period; 
an attempt to lay down rules for the recognition of 
those cases, regarded by society as half correct, and yet 
fully within the borders of crime-land. 
In view of what may be safely regarded as a fact, 
that deception of this nature is often successfully at- 
tempted, I am induced to make an effort to systematize 
our knowledge of this important matter. Ho physician 
wishes to be made a Judas to betray unwittingly his 
master. .[As society now looks upon this sin, we must 
be always on our guard. Wives will even make the 
hazardous attempt to keep both husband and physician 
in ignorance of the procured abortion. 
I have reason to believe that there exist among us 
the Science and the Art of Abortion. The worship of 
the goddess Aphrodite finds its father-confessor in the 
foeticide. 
The married woman, who gives to society the woman- 
hood she ought to give to humanity, seeks the abortion- 8 
ist, and by the outlay of a few dollars shirks the high 
destiny of a mother// 
The luxury of an abortion is now within the reach 
of the serving-girl. An old man in this city performs 
this service for ten dollars, and takes his pay in instal- 
ments. 
Let the following instance illustrate the reckless dis- 
regard some women, who possess this moral obliquity, 
have of the rights of the husband. It is only a year or 
so ago, that a woman, young and interesting, and the wife 
of a young medical man, came to me for such a purpose. 
When I stated the certainty of detection by her hus- 
band, from the symptoms, she informed me, to my great 
surprise, that she had once successfully carried out such 
a plan of deception. Her husband supposed the " show ” 
was a healthy renewal of her menses, Avhich are often- 
times profuse, after an interruption of two or three 
months. I watched her from the window of my office, 
and saw her enter the den of a notorious abortionist 
nearly opposite. I have no doubt of her success in 
again deceiving her husband. He was a man of aver- 
age medical attainment, and had served as a surgeon 
during the late Avar. 
For the physician to stand by the bedside of a pa- 
tient, unconscious that such a sacrilege is being perpe- 
trated in the holiest of a woman’s nature, does him ir- 
reparable injury, and inflicts an equal amount of injury 
upon society. 
Crime will increase in proportion to the lessening of 
its chances of detection. 
That Avhich renders the detection of these cases diffi- 
cult is the early period of gestation in which criminal 
interference is procured. In the great majority, the 
third menstrual lapse is the signal for interference on 
the part of the woman. In a case that occurred to me in January, 1871, a case of asserted interruption of the 
catamenial discharge " from taking cold,” the patient, 
a young married woman, was two months pregnant. I 
detected the fraud on my third visit. Among women 
who have achieved the difficult feat of auto-catheterism 
of the uterine cavity, they usually probe themselves at 
the expiration of the first month, if the menses are 
tardy in their return. I know of several such model 
country-women; and have had many other cases of like 
nature related to me by other practitioners. Instances 
of self-probing at this early period rarely come under the 
notice of the medical man, except for hemorrhage, 
called by the patient " such a long time unwell,” and 
then it is possible for the acutest physician to be at fault. 
I think I may safely assert that the second and third 
months constitute the crisis in the uterine life of the 
foetus, among women who are subject to this moral 
obliquity. Generally, married women have a whole- 
some fear of criminal interference after the fourth 
month, from the belief that foetal life is then fully de- 
veloped. This idea is the balm in Gilead to the con- 
science of every married woman; and the prevalent 
theory among ” nice ” women is, that before that time 
w no particular harm is done.” It may be stated as a 
rule, that it is only among women who have a greater 
fear of children than of transgressing the divine ordi- 
nance, " Thou shalt not kill,” that any measures are taken 
to arrest the progress of gestation after the period 
named. I speak of the married only, as no rule will 
apply to those who bear the fruit of illegitimate concep- 
tion. The physician is called upon to visit two classes 
of cases. 
(a.) Those in which the abortion is admitted, but its 
criminal cause denied. 
(&.) Those in which the sickness is referred to some 10 
cause foreign to a pending abortion. The first class 
(a.) is generally met with among married women, and 
of the two is the less difficult of detection. The. woman 
generally refers the unhappy state to a fall, or blow, or 
the sudden knowledge of unhappy news, or alarm, or 
that an abortion is habitual with her, and she fears that 
she will never have a living child. She refers her con- 
dition to one or the other of the above causes with 
such an air of sincerity, that it seems pure heartlessness 
for her physician to doubt. 
In the first place, it is reasonable ground for sus- 
picion, that a miscarriage is occurring in a young married 
woman, of previously good health, between the second 
and third months. If an abortion occurs in those early 
months from any disease of the maternal system it is 
generally, according to the classification of M. Guille- 
mot, ovular. Even syphilis, than which no disease af- 
fects the system of the mother more disastrously, does 
not usually endanger the product of conception until 
the later months. (Duval.) It is rare, and I think the 
experience of all physicians will sustain me, that a 
spontaneous abortion occurs between the third and 
fifth months. 
The history of the woman being known, and her ap- 
pearance verifying the history that there is no constitu- 
tional taint, or state of confirmed ill-health, the ques- 
tion to be considered is, Does the reason given by the 
woman amount to a sufficient cause for the abortion? 
The evidence upon this point may be gathered from 
two sources; the history, from the occurrence of the 
alleged cause to the time of examination, and the evi- 
dence furnished by the touch. 
A fall or blow upon the abdomen should leave some 
point of soreness or ecchymosis upon a portion of the 
body favorable to an abortion; thus, a sore point, or 11 
ecchymosis upon the shoulders, arms, or legs, although 
confirming the fact of the receipt of an injury, would not, 
in the absence of similar marks in regions obnoxious to 
an abortion, verify the statement of the patient. Still, 
in the case of a nervous, excitable woman, who had 
previously suffered a spontaneous abortion, due allow- 
ance should be given for the effects of shock. In a case 
that came to my notice some years back, the woman al- 
leged that the miscarriage at between three and four 
months was caused by a kick upon the abdomen from 
the husband, and exhibited marks in that region to veri- 
fy her statement. It was shown afterwards that a wo- 
man had probed her womb some time (six or eight days) 
after the injury to the abdomen. 
In the matter of an alleged fall, as in descending 
stairs, in the first weeks of gestation, the ovum is driven 
out oftentimes, on the principle of forcing a cork from a 
half-filled bottle by the sudden concussion (Cazeaux). 
It never occurs in this manner after instrumental inter- 
ference. 
A careful examination as to time is an important ele- 
ment in the case. By a study of the table of contrast 
it will be seen that the severe symptoms are inverted; 
that the spontaneous abortion begins without shock, the 
abortion from manipulation almost always with more or 
less severe constitutional disturbance, or with persistent 
abdominal or lumbar pain. The shock prevails in the 
forced abortion, for this reason: the cavity of the womb 
has been invaded; always with an instrument like a 
sound, or by an injection of water. Those of us who 
have injected the cavity of the unimpregnated womb 
know how liable it is to be followed by pain or shock; 
how much more persistent must be the symptoms of evil 
when the cavity of the uterus is injected with a crimi- 
nal purpose, and is subjected to rough manipulation, 12 
when this — the key organ of a woman’s system — is 
undergoing radical physiological changes. The instru- 
mental abortion often has expulsive pain immediately 
following the interference. The spontaneous or acci- 
dental abortion never presents this as an initial symp- 
tom. The reason is clear. If an injection has been 
used by the foeticide, the uterus is at once so circum- 
stanced that demands are made on its expulsive power. 
The uterus rarely fails to respond to the demand. If 
the ovum is detached the conditions are still the same. 
Another symptom characteristic of the abortion by 
manipulation, and occurring within a period varying from 
a few hours to two days, is a marked tenderness of the . 
hypogastrium, often diffused over the abdomen at large, 
gradually lessening in intensity as it recedes from the 
region of the jmbes. Those who have had experience 
in this matter tell me that it is truly surprising how rap- 
idly the abdomen will become tender to the touch, and 
the pulse mount up to the neighborhood of a hundred, 
and still nothing serious result, after an injection into 
the gravid womb. The womb, when interfered with at 
about the third month of gestation, may also be feit en- 
larged and tender above the pubes; but this symptom is 
not so common as hypogastric tenderness, which is rare- 
ly, if ever, absent. 
Accidental and Spontaneous Abor- 
tion, to the Third Month. 
Ovular abortion may occur and sim- 
ulate dysmenorrhoea. Later; a grad- 
ual climax of symptoms, thus : loss of 
appetite, depression of spirits, pain in 
loins, weight at anus or vulva, pain in 
breasts, followed by hemorrhage and 
expulsive pains in uterus. 
From accident, sharp pain in back, 
loins, or abdomen; often an interval of 
DIFFERENTIAL DIAGNOSIS. 
Instrumental Abortion, to the Third 
Month. 
Marked constitutional disturbance 
from the first. Rigors, fainting or col- 
lapse, pain severe in hypogastrium, 
often extending over the entire abdo- 
men, and marked tenderness on pres- 
sure. 
Expulsive pains before the hemor- 
rhage. Pain severe in back and in a 
line from umbilicus to sacrum, pain and 13 
a day or two or more, and then pains 
renewed violently and bleeding. 
Evidence of history; habitual abor- 
tion, previous ill-health, or plethoric 
state. 
Often a history of uterine displace- 
ment. 
As a rule, pulse rarely reaches 100. 
As a rule, there are no symptoms of 
inflammatory complications of uterus 
or abdominal viscera. 
hemorrhage occurring together. Large 
clots. 
Evidence of history. Previous good 
health. Evidence of habitual abortion 
absent or doubtful. 
As a rule, pulse from 100 to 120. 
As a rule, always symptoms of in- 
flammatory complications, tenderness 
on pressure over uterus. Os and cer- 
vix enlarged and extremely tender to 
the touch. 
Now, if the examination of the woman, or her hus- 
band, or others, establishes the fact that the severe 
shock was among the initial symptoms, followed quick- 
ly by expulsive pains; and if, in addition to this, the 
hand to the abdomen gives evidence of marked hypo- 
gastric tenderness, we are fairly at liberty to conclude 
that we have before us a case of forced abortion, not- 
withstanding the denial of the patient. If the ques- 
tions to the patient are skilfully put, the above facts 
may generally be readily elicted; as in most cases they 
are ignorant of any peculiarity in their case, one abor- 
tion being as good as another in womanly eyes. 
In this class of cases, there is no obstacle of course 
to a digital examination, which may afford evidence 
so completely corroborative of the conclusions based 
upon the above signs, that the physician may acquit his 
conscience of any injustice towards his patient. The 
evidence furnished by the touch is the second source 
from which we obtain facts as to the guilt of our pa- 
tient. 
One of the first symptoms brought to light by digital 
exploration is great heat and fulness of the vaginal 
passage. The rugae of the vagina are thickened from 
congestion, and seem to be unusually sensitive, grasp- 
ing the finger with more or less force. This vaginal 
hypersesthesia is generally found associated with abdomi- 14 
nal tenderness. It may be found in the spontaneous or 
accidental abortion in those rare cases in which inflam- 
matory complications obtrude. Knowing, however, the 
rarity of such complications in the innocent abortion, 
we are justified in regarding this as further evidence of 
criminality. 
The os uteri is always tender, usually so much so 
that the most careless observer must remark it. The 
innocent abortion may, and often does, present the same 
feature, but rarely the exquisite tenderness of the cases 
refeered to. The uterine pain to the touch is so con- 
stantly present, that it is independent of the presence 
of abdominal pain and tenderness on pressure. It may 
be present in a few hours after the use of the in- 
strument, but usually is present after the first day. 
Those who have been favorably situated to study this 
symptom in the forced abortion, inform me that, al- 
though it may be present to such a degree that an ex- 
amination is impossible, still it is not a reliable datum for 
prognosis. It is difficult to explain this uterine tender- 
ness, unless we regard it as the result of the inflamma- 
tory engorgement, dependent on the untimely and 
sudden demand made upon the expulsive power of an 
organ entirely unprepared for such an effort. 
Coincident with this tenderness of the cervix is 
an engorged condition of that part of the uterus, 
which, in all probability, is common to the body and 
fundus of the organ. This, undoubtedly, is the condi- 
tion when the uterus can be felt above the pubes. This 
state of the body and cervix may be present in the 
spontaneous abortion, but it would not exist to any 
great extent, unless associated with inflammation. 
There is still one more peculiarity of these cases re- 
vealed by the touch. This is an oedematous condition 
of the cervix, in which the margin surrounding the 15 
opening of the canal may be enlarged, giving that soft, 
bag-like feel peculiar to tissues infiltrated with serum, 
beyond which the body of the cervix may be per- 
ceived smaller than the lips. This is a condition more 
often met with in the instrumental abortion under the 
third month, and not of necessity associated with the 
more serious inflammatory symptoms already men- 
tioned. 
This concludes the description of the symptoms which 
characterize this class of abortions, and from which, I 
think, if carefully and judiciously applied, we may be 
able to satisfy ourselves as to the existence of a criminal 
element in the case, and not be guilty of any injustice 
to our patient. 
(b.) Those cases in which the sicJcness is referred to some 
cause foreign to a pending abortion. From the nature 
of things, we would meet this class of cases only 
among the unmarried; and when the physician is brought 
in contact with them, the acutest may be at fault. In 
the first class detection was comparatively easy; but 
here the woman is making her best effort to defend the 
remnant of her honor. Hot only do we have the cun- 
ning of the woman to deal with, but she is often in- 
structed by the abortionist as to her conduct, if it be- 
comes necessary to call in a physician. A man gray 
and crippled by years, and who out-Herods Herod, I 
am told makes it a practice to instruct his patrons, who 
are novices in the mysteries of premature motherhood, 
how to avoid confessing their shame. How is a physi- 
cian to distinguish the hemorrhage of an abortion at 
six weeks from the flow of a menorrhagia or dysmen- 
orrhoea? It is no impeachment of the acuteness of the 
practitioner to say, that many cases may occur in which 
it would be almost impossible to discriminate between 
them. The bloody discharge may clot in both cases, 16 
there may be expulsive pains in both, and tenderness of 
the abdomen, back-ache, and fever. You cannot find 
the ovum, if expelled, for the woman cares that you 
shall not. She will not permit an examination. How- 
ever, I believe there are but few cases in which pro- 
cured ovular abortion takes the kindly course of a 
dysmenorrhcea. With this last disorder, especially after 
a menolipsis, it is most liable to be confounded. Cases 
may occur in which the physician, judging from the 
social position and known character of the patient, has 
no right to suspect an abortion; but in whom foeticide 
has taken place. It is woman’s mission to love, and she 
may not love wisely among the rich as among the low- 
ly. The patient expects, and rightly too, that the ex- 
cessive flow of an abortion can be arrested without her 
medical adviser knowing the real difficulty. If the 
ovum has escaped and left no remnant behind, the 
measures which would arrest an inordinate menstrual 
flow would tend to abate the hemorrhage of an abor- 
tion. The same remark applies to pain. It is for this 
reason, if the patient has been instructed, that she 
clings to her secret. 
The following table will exhibit all we know of the 
difference between dysmenorrhoea and forced abortion. 
DYSMENORRIIQEA. 
Previous attacks. Pain most severe 
just before discharge. Pain relieved by 
the flow. Pain more often ovarian 
than uterine, except in cases of reten- 
tion, when the pain is expulsive. Pain 
in loins and thighs. 
Shreds of membrane in discharge. 
Fever not severe or pulse high, as a 
rule. 
No dangerous inflammatory compli- 
cations. 
History furnishes evidence of ill- 
health. 
INSTRUMENTAL ABORTION. 
Absence of menses two periods or 
more. No previous history of dys- 
menorrhoea. Rigors and severe con- 
stitutional disturbance. Pain not re- 
lieved by discharge. Pain and discharge 
occur together. Pain more marked in 
uterus than in ovaries. Tenderness 
acute over abdomen and uterus. 
No membrane in discharge. 
Fever, and pulse 100 and over. 
Dangerous inflammatory symptoms 
commdn. 
History of previous good health. Manner of patient free from sus- 
picion. 
Manner suspicious. 
Possibly expelled ovum may be seen. 
Great reluctance to vaginal examina- 
tion. 
When called to a case of dysmenorrhoea or menor- 
rhagia, what circumstances would lead us to suspect a 
pending abortion? I believe that if the manner of the 
patient did not cast suspicion on the case, the character 
and situation of the pain would. On this point the oral 
examination of the patient ought to be as rigid as possi- 
ble, and not excite her fear or hostility. As to the part of 
the womb which is the exciting cause of pain, Dr. Snow 
Beck * has given some useful hints. When the cervical 
part is involved there may be reflected pain in the lower 
lumbar region, the hips, the iliac, inguinal and hypo- 
gastric regions, and the inner part of the thighs. Dr. 
Graily Hewitt believes this to be true. This would ac- 
count for pain, in the positions named above, in cases 
of undue narrowness of the cervical canal. In con- 
trast to this the pain of abortion would be uterine, and 
radiate from this point to the back and loins. The pain 
of menstrual retention may be periodic, like those of 
labor, f but we have this cardinal symptom to guide 
us, — the expulsive pain of dysmenorrhoea due to 
menstrual retention is always accompanied by scanty 
discharge, or by a discharge occurring in gushes, 
with relief in the pain of some hours, duration; while 
the pain and discharge of an abortion occur together, 
the hemorrhage not in any way lessening the intensity 
of the expulsive pains. Another diagnostic point to be 
observed in dysmenorrhoea is, that an arrest of a 
catamenial flow is followed by a marked exacerbation 
of pain; while in abortion the cessation of the discharge 
is generally the signal for an abatement of the pain, 
* Medical Times, 1851, Vol. xxm., p. 583. 
t Hewitt, p. 118. 18 
or never tends to intensify it. Shreds of membrane in 
the discharge would at once decide the case in favor of 
dysmenorrhoea. One word as to the manner of the pa- 
tient. If the woman is actually suffering from a crimi- 
nal abortion, the very consciousness of being examined 
by one whom she supposes able to detect her state, would 
be apt to lend a peculiar reticence to her statements 
about symptoms she regarded as characteristic of an 
abortion. If the patient was in great suffering, the 
physician would have to settle the matter with his own 
conscience as to the propriety of wringing a confession 
from her by means of her fears. 
An examination as to the character of the discharge 
may throw some light on the case. From the menor- 
rhagic discharge being generally free from the severe 
pain usually found in abortion, except in those rare 
cases in which a forced abortion would be almost pain- 
less, and also being seldom met with in the young and 
healthy female, I throw it out of consideration. The 
discharge of an abortion would invariably form vaginal 
clots, irrespective of quantity, the conditions which 
render the discharge of the menses uncoagulative 
being reversed in case of abortion; the discharge of a 
dysmenorrhcea never clots; if it were so free as to clot, 
the expulsive pains would cease, or abate; but as a rule 
the discharge is not coagulable, being so slight usually 
that the vaginal and uterine secretion prevent. Again, 
the hemorrhage of an abortion occurs in gushes, syn- 
chronous with the expulsive pain,* and at each pause 
there is a cessation of pain; while in dysmenorrhoea, 
as already stated, the gush is followed by a consid- 
erable interval of freedom from pain. There is gen- 
erally a periodicity in the hemorrhage of an abortion 
rarely seen in the disease with which I am contrast- 
* Hewitt, p. 67. 19 
ing it. The manner in which the abortion is brought 
about may also present a symptom quite characteris- 
tic. Having taken considerable trouble to ascertain 
the most common method, I believe an injection of 
water into the cavity of the womb is the means gener- 
ally relied on by abortionists. In two cases which I at- 
tended,. the result of the interference of an abortionist 
of this city, the symptoms were begun by the discharge 
of water tinged with blood for some hours before actual 
hemorrhage commenced. Both cases were at the third 
month of gestation. If called to a case of alleged dys- 
menorrhoea, in which active inflammatory symptoms 
were present, with acute tenderness of the abdomen, and 
a pulse at one hundred and twenty or upwards, at- 
tended with periodic pain and hemorrhage, I should feel 
justified in regarding the case with suspicion. 
In those cases in which our suspicions lead us to in- 
sist upon a vaginal exploration, we gain important in- 
formation, already referred to in a former part of this 
paper. In one of the two cases just mentioned an ex- 
amination was refused, the patient appearing to suffer 
from severe shock to her modesty. On being kindly 
reasoned with, she ackowledged her condition, but not 
until danger was imminent. 
In this class of cases, if an examination of the womb 
be made, the attention should be directed to two points: 
the dilated os, and the possibility of the ovum or frag- 
ment of placenta protruding. If the finger detects a 
soft, tender, dilated, and yielding os, a state is revealed 
totally at variance with the conditions essential to dys- 
menorrhcea. If the ovum was detected in the dilated os, 
it would at once settle the question. If the placenta, or 
a fragment of it, presents at the external os, the diagnosis 
would rest between a polypus or placenta. The previous 
history would confirm or exclude the idea of polypus. 20 
The sequelae may tend to confirm or remove linger- 
ing doubts. In a case of dysmenorrhcea, after the 
womb has completed its menstrual molimen, the woman, 
as a rule, is restored to a condition of comparative com- 
fort; but in the abortion there is generally loitering 
tenderness of the abdomen, aggravated by standing or 
walking; often recurring attacks of hemorrhage, from 
a slight show to severe hemorrhage, independent of any 
periodicity; dragging at the loins, and a sense of weight 
at the anus or vulva. These symptoms may persist 
for an indefinite time. I have no doubt but the family 
physician is often called upon to treat these symptoms, 
and without any suspicion of criminal antecedents. 
The practitioner ought to bear in mind that the instru- 
mental abortion, procured with malicious intent, presents 
almost always features of malignancy. It is isolated 
by these features from other accidents of the puerperal 
state. The innocent abortion is preluded by nature 
with organic changes which fit the womb for the ex- 
pulsion of its contents. In the forced abortion demands 
are made upon a healthy organ for it to instantly vio- 
late the laws of its physiological action. This I believe 
to be the key to the difference between the two cases. CHAPTER n. 
OTHER POINTS IN THE DIAGNOSIS OF INSTRUMENTAL 
ABORTION. 
In the previous chapter I have endeavored to define 
the crime as it usually appears when induced by the 
injection of water into the cavity of the womb. Various 
methods are made use of to perpetrate this crime instru- 
mentally. In America, when medical men lend them- 
selves out as abortionists, I believe they commonly 
induce it in the manner spoken of in the opening sentence. 
In Paris, the puncture of the membranes is generally 
resorted to. (Med. Chirurg. Review, xxix. p. 604.) 
Violence of a very different nature results from the two 
procedures. In one it is the violence of over-distention. 
In the other, direct injury is done to the membranes, 
and the violence of lessened distention — - a sudden with- 
drawal of the normal distending force. These measures, 
having such opposite mechanical results, must, from the 
nature of things, produce a difference in the resulting 
symptoms. It is probable that the majority of the cases 
of self-probing practised by many women result in a 
rupture of the amniotic pouch. 
Various instruments are used for this purpose. The 
stylet within a curved tube, a bougie, an iron wire, a 
knitting-needle, and a piece of whalebone are all of them 
instruments for rupturing the foetal membranes, or for 
breaking up its attachments with the womb. It is also 
probable that rude manipulation, if the placenta is situated 
low and anteriorly, may partially or wholly separate 
that mass from its uterine connection. Fatal results 22 
from self-probing are often heard of. A physician 
related one case in which a woman inflicted upon herself 
seven punctures in her womb with a knitting-needle, 
and fatal inflammation resulted. 
When puncture of the membranes is resorted to, the 
first sign is a dripping of the amniotic fluid, very little 
pain or shock. A German woman, who, in the fourth 
month of pregnancy, was operated on in a physician’s 
office by rupture of the membranes, informed me that her 
person was very wet with the escaped fluid when she 
reached home. It continued to drip away from her for 
nearly two days, when pains came on, rapidly increasing 
in severity until the abortion occurred, early in the third 
day. This, then, is the distinguishing feature of this 
form of the crime. If the woman alleges that the abor- 
tion came on in the above manner after an injury or 
fright, we have every reason to believe she is telling an 
untruth. In case the placenta is wounded, hemorrhage 
will be coincident with the discharge of the amniotic 
fluid. Stains caused by the liquor amnii upon the 
patient’s linen, if fresh, might be detected by its sper- 
matic odor and yellowisli-gray color. There are no 
chemical or microscopic tests by which a stain of liquor 
amnii dried upon linen can be identified. (Taylor, Med. 
Jm\, p. 445, Am. Ed.) In case the neck or body of the 
womb is wounded by rude manipulation, arterial hemor- 
rhage would be at once evident, followed shortly after 
by tenderness, heat, and pain, and which so rapidly 
assumes a grave character that probably the nature of 
the trouble would soon be evident. The case so com- 
plicated would stand thus: without any previous pain to 
indicate uterine contraction, and in a state of health, 
there would be a sudden discharge of water from the 
vagina, with a more or less abundant hemorrhage, steady 
and persistent like the hemorrhage from a wound, and 23 
this would preclude either a state of active inflammation 
or an abortion. 
Abortion induced by Electricity. — I was shown in the 
shop of an instrument-maker an instrument designed to 
throw a current of electricity through the womb. One 
pole, insulated in a glass tube, was constructed to be 
placed at the neck of the womb, while the other pole 
was placed over the abdomen, and thus the organ could 
be roused into contraction from the direct stimulus of 
the electric current. To what extent this truly diaboli- 
cal little instrument is used I cannot say; nor do I know 
what modification the symptoms of the resulting abortion 
would undergo. 
The instrument-maker informed me he sold them to 
physicians. 
The evidence of criminality furnished by the foetus 
after birth requires a brief consideration. When preg- 
nancy has advanced beyond the period of quickening, 
before any means are taken to procure an abortion, the 
foetus may be delivered in a living condition. The fact 
that an immature foetus exhibits life, as in cases men- 
tioned by Cooper and d’Angers (Storer and Heard, 
Criminal Abortion, p. 92), after delivery, is a strong 
evidence of criminality. It would be the exception, as 
experience proves, for a foetus to be born living, after 
four months and under six months of gestation, when 
the abortion was the result of natural, slow-acting causes. 
Whatever may be the factors of a slow-acting natural 
cause of an abortion, they strike at the root of the 
viability of the foetus. It is either a maternal error or 
a foetal error, and either is fatal to its tender life. The 
fact that the foetus is viable at the time of birth is an 
indication of the working of some cause other than a 
slow-acting ond. Taking into account those exceptions, 
which always must be looked for, and in these cases 24 
must be given their due value, the viability of the foetus 
after delivery must be explained as the result of a sud- 
denly determining cause, either accidental or criminal. 
If the weight of proof is in favor of criminality, it is 
strong evidence of instrumental interference, as the use 
of abortient drugs is in itself a slow-acting cause. If 
this sign is taken, in connection with the symptoms 
already given, as corroborative, it becomes of great 
value. It will be rarely met with, however, as in the 
married it is unusual to allow gestation to progress so 
far as to render the occurrence of this sign possible. 
On the evidence furnished by shreds of membrane in 
the discharge considerable embarrassment may arise. 
I was called in May, 1871, to see a young married 
woman, but at that time a kept mistress. She had 
passed over one catamenia. When I saw her there 
were expulsive pains, hemorrhage, the formation of 
small clots, and right ovarian pain. During the night 
of the third day of the attack, she expelled a substance 
the nature of which she was unable to determine, and 
saved it for my inspection. I found what appeared to 
be shreds of membrane, of a pinkish color, mixed with 
firm coagulum. The membrane preserved its integrity 
after repeated washings. 
The question arose, was it a dysmenorrhoeal membrane, 
or a remnant of a foetal envelope ? My friend, Dr. Van 
Duyn, examined it under the microscope, and found it 
consisted of a network of fibrine, interlacing red blood 
globules. It was simply an anomalous clot. It was of 
uterine formation, which accounted for its decolorized, 
membraneous character. 
When suspicion is aroused of a pending criminal 
abortion, a slight incident may appear important. We 
must be careful how we give way to evidence that we 
do not use all our knowledge to test. 25 
A young unmarried woman may void a dysmenorrhceal 
membrane under circumstances so suspicious that we 
deem her guilty of an abortion at once. It is, therefore, 
important that we should study briefly the nature and 
appearance of this membrane. The following case is 
very instructive. Dr. Beatty presented to the Patho- 
logical Society of Dublin a membrane thrown off during 
difficult menstruation by a young married woman, who 
for twelve months previously, had voided one of these 
membranes monthly. It resembled in all its appear- 
ances a decidua vera of the fourth month. Dr. Beatty 
said that no obstetrician, however experienced, could 
take on himself to say that it was not the result of 
impregnation. (Dublin Hospital Gazette, June 1,1861, 
p. 172.) 
A dysmenorrhceal membrane is a true membrane, and 
is not the result of the exudation of coagulable lymph 
or fibrine upon the free surface of the mucous lining of 
the uterus. Sir J. Y. Simpson proves it to be the true 
mucous lining of the uterus, and in which, as pointed 
out by the researches of Sharpy, Weber, Goodsir, and 
others, the decidua vera has its origin. (Monthly Jour. 
Med. Sci., Sept., 1S46, p. 161.) Dr. Oldham maintains 
the same origin for the dysmenorrhceal membrane, and 
claims priority in his views, as he certainly does in pub- 
lication. (Medical Gazette, April 16,1846.) Dr. Gran- 
ville, in his work on abortion and diseases of menstrua- 
tion, has figured the membranes from a long series of 
cases. 
The dysmenorrheal membrane presents features which 
distinguish it in a marked manner usually. There is in 
the first place generally, a history of dysmenorrhoea, and 
fragments of membrane are found on the napkin or in 
the vessel in the morning. It presents the appearance 
of true mucous membrane,, and it is marked with numer- 26 
ous orifices of the uterine glands. It is sometimes 
thrown off entire, and has the flattened, triangular 
shape of the uterine cavity, and a large opening at each 
angle corresponding to the openings of the Fallopian 
tubes and the cervix uteri. The external surface is 
rough and shaggy, the effects of dilaceration from the 
sub-mucous layer. More usually it is discharged in 
pieces, and then it will present a smooth or internal 
surface and the rough external. The smooth surface 
presents the characteristics of true mucous membrane 
with its mucous follicles. The membrane is more often 
discharged as shreds, or in strings, which have to be 
carefully washed out in order to verify them. The 
appearance of the rough side with the smooth obverse 
puts the case beyond doubt. (Monthly Jour. Med. Sci., 
Sept., 1846.) 
The contrast to this of the foetal membranes is evi- 
dent at once, their thin, transparent appearance, and 
a different history, and if in case of doubt the microscope 
test will settle the point. There is more danger of 
mistaking the decolorized clot for foetal membranes than 
this cast-off mucous lining. There is moral evidence 
which the physician should also observe. The mere 
fact of having his attention called to clots or fragments 
is an evidence of innocence. Those guilty of the 
criminal abortion submit the discharge to an examination 
with the greatest reluctance. By this moral evidence 
in suspected cases the physician must constantly be 
prepared to profit. A marked suspicion of the medical 
attendant, and an unwillingness to have the bed, napkin, 
or vessel examined, ought to send the physician on a 
tour of discovery at once. He will oftentimes find 
enough to reward him. 
Diagnosis of retained Placenta. — It is important that 
we should be able to discriminate between a uterine 27 
polypus and a retained placenta. In the proceedings 
of the Gynecological Society of Boston (Journal of the 
Gyn. Soc. of Boston, May, 1871, p. 273) a case was 
presented, in which an unmarried girl, seventeen years 
old, barely out of school, was the subject of alarming 
hemorrhage, and which forcibly illustrates many of the 
facts presented in my second (b) class of abortions. 
The girl having suffered an abortion, it is probable no 
physician was called until alarming hemorrhage ensued, 
and was then diagnosed as a descending uterine polypus. 
Two days subsequently Dr. Storer settled the diagnosis 
by-removing with polypus forceps an evidently placental 
mass. In this case there was a history of regular men- 
strual periods, which was undoubtedly a fabrication on 
the part of either the patient or her friends. 
As a rule in these cases we should regard with doubt 
all statements made by the patient or her friends which 
are at variance with what ought, in the usual order of 
nature, to be a regular sequence of symptoms. 
A very simple means of detection would be a pro- 
truding cord; but this I believe to be extremely rare 
in abortions in the early months, from its extreme short- 
ness and friability. Another sign, still more common, 
to which our attention, in cases open to suspicion, ought 
to be alive, is shreds of membrane protruding from the 
os, and still attached to the placental mass. These may 
present the appearance of stringy shreds, with uneven 
extremities hanging free from the external os. ISTo 
recorded case of polypus is known to the author which 
would present a membranous envelope; nor no disinte- 
gration to which a polypus is liable would result in a 
membranous fringe. 
It is in those cases, however, in which neither cord 
nor membrane presents, and possibly in which nothing 
whatever is apprehended by the finger in the examina- 28 
tion, as in the last reference, which makes this question 
a point of extreme delicacy. 
It is possible for a polypus to present the symptoms 
of an abortion (loc. cit. p. 275); but in that case it is 
safe to say there would be elements wanting, which, in 
the criminal cases, would guide us in forming an opinion. 
It is only to those cases in which a presenting polypus 
with the attendant hemorrhage might mislead us that 
an abortion had occurred; or the occurrence of hemor- 
rhage and a presenting tumor at the os, in a young and 
unmarried girl, might lead us to overlook the possibility 
of a criminal antecedent, that we need pay attention. 
In the contractile efforts of the womb to expel a 
placenta, the lowest part of the placental circumference 
would be the presenting part; this circumstance would 
render it almost impossible for the smooth, polished, and 
uniform foetal surface to present at either the internal 
or external os. The fact that the placenta is usually 
inverted at term, when delivered, is not an objection to 
the above, for the inversion occurs in delivery, and not 
in the act of spontaneous presentation at the os. The 
touch would thus detect the rough and irregular exter- 
nal surface of the placenta. If the os is sufficiently 
dilated to admit the introduction of the finger, exami- 
nation ought to be made of both surfaces of the present- 
ing tumor, and the finger detecting the marked differ- 
ence in the two placental surfaces, a condition would 
be revealed which ought to aid the diagnosis materially. 
The touch may still further prove useful in cases of 
doubt, as showing the contrast in properties of polypi 
and placentae. In case of mucous polypus, if developed 
in the cavity of the body of the womb, it is flat, or leaf- 
shaped generally (Dr. Saexinger, Amer. Journal of 
Obstetrics, vol. i, p. 232), or pear or club shaped, 
smooth, soft, and uniform to the touch. In the fibrous 29 
polypus the tumor is firm, hard, and smooth, and as a 
fibroid always originates in submucous stratum (Dr. 
Saexinger, loc. cit.), it is consequently covered with 
mucous membrane, and by small indentations on the 
surface, caused by obliterated utricular glands. If the 
fibroid has undergone surface degeneration, there is felt 
a spongy, felt-like stratum, beneath which may be dis- 
tinguished the firm and fibrous mass, — a sensation very 
much like that given by the touch of the os of the 
gravid womb. The placental characteristics to the 
touch are marked, — the irregular cotyledons of the 
uterine surface, the membrane-covered foetal surface, 
the leaf-like edge of the presenting part, and lastly, a 
circumstance which I have often remarked, but have 
never seen referred to, a sense of crepitation under the 
finger, a sort of spleen-like feel, and which sensation I 
have explained by the giving away of the elastic walls 
of placental veins and sinuses. 
Evidence from the Areola and Breasts.— Any evi- 
dence we might seek from the areola, or increased size 
of the mammary gland in the young unmarried female, 
would usually be as difficult to procure as evidence from 
the vaginal touch. It is probable that in case the breasts 
were examined but little corroborative evidence of preg- 
nancy could be procured, as the early period at which a 
young unmarried woman would seek instrumental inter- 
ference would antedate the period at which the mam- 
mary signs attain their full value. 
If called to a young woman whom we have reason to 
suspect guilty of an abortion, it would be well to pay 
attention to the fact that a scanty lactation may be 
established from one to two or three days after the sus- 
pected abortion. It would be the exception to find this 
mammary excitement absent after an abortion at the 
fourth month. Heat and fulness of the breasts may be 30 
evident in an abortion at the third month. It is thus 
that we may find positive evidence of guilt on the part 
of our young patient in the condition of the breasts. It 
would be a difficult point to investigate in a woman 
thoroughly on her guard; and how closely she watches 
herself and others none but those who have studied 
these sinister lines in a woman’s character can know. 
She guards with all the keenness of her quick wit the 
casket, after the jewel has been stolen, or rather 
bestowed. 
Evidence from Temperature. — Although the temper- 
ature of the body taken alone would be of little value 
as a means of detection, still it ought to be studied in 
connection with other symptoms, and as indicating a 
case of a graver nature than the patient will sometimes 
admit. A simple dysmenorrhoea, unattended with in- 
flammatory complications, would not give an elevation 
of temperature above the normal mean range. As a 
means of detecting an inflammatory tendency, or an 
actually existing inflammation, the thermometer is un- 
erring. In the average of cases of dysmenorrhoea, I 
believe, the bodily heat is but little disturbed. In one 
case which I observed thermometrically, but not as 
regularly as was desirable, the temperature was below 
the mean 98° or 99° F. (Dr. Sidney Dinger, London 
Lancet, 1866, p. 115, Amer. Ed.), having a mean range 
for seven observations of 97.75°. The case was at- 
tended with slow, feeble pidse and nervous depression, 
a condition in which we would infer depressed systemic 
heat. 31 
The following is the thermometry of a case of 
dysmenorrhcea, such attacks being habitual, the one 
observed being one of ordinary severity. The subject 
is twenty-four years of age, unmarried, spare, and of 
nervous temperament. The pain in the attacks was 
mostly ovarian. 
Hour. 
Thermometer. 
Pulse. 
Day. 
9.30 A. M 
99.15° 
84 
1st. 
5.15 P. M 
99.25° 
88 
9 A. M 
99° 
80 
2d. 
6P.M 
99° 
90 
\ 
8.45 A. M 
99.30° 
80 
*6 
co 
5.30 P. M 
99° 
87 
9 A. M 
98.85° 
78 
4th. 
6 P. M 
99.25° 
80 
It will be observed that the increase in range reached 
its maximum on the third day, and was only 0.30° 
above the normal standard of Ringer. From the general 
appearance of the case, I am disposed to think that it 
was owing to the recovery of the system from nervous 
shock that the thermometer was at its highest range on 
that day, the pain being much lessened. 
In another case of dysmenorrhoea from obstruction, 
the temperature was much above the normal. The ex- 
pulsive pains were strong and regular with much dis- 
turbance of the system. 32 
Hour. 
Thermometer. 
Pulse. 
Bay. 
9.40 A. M 
98.75° 
98 
1st. 
5 P. M 
100° 
t 
120 
8 A. M 
100.15° 
11G 
2d. 
6P.M 
100.25° 
120 
8.45 A. M 
99° 
92 
3d. 
Although the thermometer in these cases cannot be 
relied on for positive results, still it may be of use, as 
pointing to some grave disturbance of the system. In 
the forced criminal abortion we have the factors present 
which result in a morbid elevation of temperature. In 
dysmenorrhcea generally the vital forces are depressed 
by pain and shock. It is rare that it presents an im- 
flammatory hypermmia sufficiently marked to give rise 
to a degree of heat that would constitute a symptom. 
In the absence of regular observations with the ther- 
mometer in these cases, I think our experience will 
place the above observation beyond doubt. 
As an evidence that mere pain does not give rise to 
increase of temperature, we may cite the pain of labor. 
This may be called healthy pain. In a perfect normal 
labor the skin is cool and moist to the touch. It is 
when the labor deviates from the normal type that 
increase of temperature becomes a symptom of the error. 
In detailing the history of the following cases I have 
been careful to note the temperature twice daily, with a 
Colombo and Tagliabue’s Fahrenheit:— 
Case I. — Mrs. R , aged twenty-one, married, the 
mother of two children, the youngest child seven months 
old. Says pregnancy was advanced two months, and 
was "operated” on by a physician who used a syringe, 
and injected what she supposed was water into her 33 
womb. I was called to attend her on the 29th, at 
10.15 P. M. Found a foetus about an inch long in a 
mass of dark clots with no sign of placenta. On ex- 
amination by the finger, I found the vaginal part of the 
neck enlarged and firm. Os well contracted. Womb 
could be felt enlarged interiorly through the vaginal 
walls. Examined externally. Womb could be detected 
enlarged to about twice the natural size, and very tender. 
Tenderness on pressure over abdomen slight. Was 
flowing slightly. No pain. 
June 30th. Flowing slightly. Os tender, but softer 
than last night. Uterus much enlarged and tender on 
pressure. Placenta not yet delivered, and not presenting. 
July 1st. Still bleeding slightly. Vaginal part of 
neck still enlarged and tender. Os not dilated. Womb 
felt externally, but softer and less tender. Abdomen 
not tender. Complains of pains in the pelvis, and heat 
and straining at the vulva. 
July 2d. Uterus still enlarged and tender. Pain 
in the uterus not so severe. Otherwise in the same 
condition. 
July 4th. Passed several clots this A. M. Os more 
patulous, but enlarged and tender. Body of womb still 
enlarged and tender. Had much pain last night in hips 
and womb. Still bleeding a small amount. 
July 5th. On getting up this A. M. passed several 
clots, which relieved her from pain which had been 
severe all night. Slight tenderness over the abdomen. 
Uterus growing less in bulk and softer, but still a 
vaginal examination gives pain. Os well contracted. 
Still bleeding slightly. Clots which were passed have 
been carefully examined by myself, but no placenta or 
fragments of it have been detected. 
July 6th. Was called early this A. M. to the patient, 
who was flowing rapidly. Found her with strong 
uterine pains; abdomen tender. Uterus firmer and less 34 
enlarged. Os open and bleeding freely, and about as 
tender to touch as on the 5th. Tenderness present over 
the abdomen. Exhibited ergot freely, and toward even- 
ing small masses, evidently placental, were passed, but 
with strong expulsive pains. 
July 7th. Patient has not flowed since last night. 
Tenderness of abdomen gone. Os well contracted and 
but slightly tender, — still evidently in an engorged con- 
dition. Sat up several hours, but suffered from pain 
through back and pelvis. Seen again in the afternoon, 
when the womb and abdomen were again tender on 
pressure. 
These cases are given in detail, as I regard the ther- 
mometry important. The following table exhibits the 
temperature and pulse of 
CASE I. 
Day. 
Hour. 
Thermometer. 
Pulse. 
June 29th 
10-30 P. M. 
100.15° 
108 
9 A. M. 
99.80° 
100 
“ 30th 
4.30 P. M. 
100° 
116 
10 A. M. 
99.85° 
92 
July 1st 
5 P. M. 
99.85° 
98 
. 9.30 A. M. 
99° 
94 
“ 2d 
* 
5.15 P. M. 
99.25° 
97 
“3d 
5 P. M. 
96 
9.20 A. M. 
99.80° 
104 
« 4 th 
5 P. M. 
100° 
112 
8.40 A. M. 
99.50° 
98 
“5 th 
5.30 P. M. 
99.50° 
102 
6 A. M. 
100° 
110 
« 6 th 
5.45 P. M. 
100.15° 
125 
9 A. M. 
99.55° 
98 
“ 7th 
6 P. M. 
99.75° 
98 35 
Case II. — Mrs. M. J. I was called to see this case 
at 1 P. M. of January 9th. She was thirty-two years of 
age, the mother of three children, the youngest nineteen 
months old. She was spare, of dark complexion, and 
bilio-nervous temperament. I found her flowing pro- 
fusely, with strong expulsive pains, and with a harassing 
ovarian pain on the right side. The os tender to the 
touch, soft and slightly dilated. The womb, distinctly 
felt above the pubes, enlarged and tender. Abdomen 
slightly tender. Has been vomiting since morning. 
States that she is at least three months gone, and was 
"operated” on at different times, beside taking pills 
ever since she had suspected her pregnancy. The pains 
continued violent, and bleeding extreme until 6.30 P. M., 
when the foetus and placenta were expelled in a mass, 
with an appalling rush of blood. During the course of 
the afternoon the abdomen was continually growing 
more tender to the touch, so that after the delivery of 
the foetus a turpentine stupe was applied to the whole 
surface of the abdomen. 
Jan. 10th, 6 A. M. Patient free from uterine pain. 
Ovaries painful and tender. Os contracted and ex- 
tremely tender. Great tenderness in the hypogastrium, 
and disappearing toward the umbilical region. Still 
bleeding slightly. 
Jan. 11th. Patient in nearly the same condition. 
Several clots passed last night. 
Jan. 12th. Patient suffers severely from pains through 
the hips and pelvis. Vomits whatever she eats or 
drinks. Heat and fulness at the vulva. Tenderness 
to touch still present. 
Jan. 13th. Vomiting ceased; generally better. 
J an. 14th. Penewed again the large doses of opiates, 
to control pain and tenderness, which were omitted yes- 
terday. Hemorrhage ceased. 36 
Jan. 15th. Tenderness and pain well under control. 
Improving. 
Jan. 16th. Improving. Mixture of turpentine and 
lard, as an application to the abdomen since the 13th, 
discontinued. 
Jan. 17th. Ceased attendance. Patient still weak, 
and with occasional attacks of lumbar pain. 
TABLE OP TEMPERATURE IN CASE II. 
Day. 
Hour. 
Thermometer. 
Pulse. 
2 P. M. 
98.85° 
98 
7.20 P. M. 
99.85° 
120 
“ 10 th 
8 A. M. 
99.80° 
100 
5.30 P. M. 
100° 
104 
“ 11th 
9 A. M. 
6.15 P. M. 
99.75° 
99.80° 
108 
100 
“ 12th 
9.20 A. M. 
100.5° 
116 
5 P. M. 
100.15° 
120 
“ 13th 
8 A. M. 
99.25° 
100 
5.45 P. M. 
99.15° 
110 
“ 14th 
9.20 A. M. 
99.85° 
104 
4.45 P. M. 
99.75° 
108 
“ isth 
9 A. M. 
99° 
106 
5.30 P. M. 
99.10° 
104 
“ 16th 
8.45 A. M. 
99.15° 
98 
5 P. M. 
99° 
94 
“ 17th 
8.30 A. M. 
99° 
98 
Case III.—Miss K , a kept mistress, was "oper- 
ated” on three times, by a man notorious as an abortionist, 
by the " injection method,” as she called it; was two months 
pregnant; stated she had been pregnant many times 37 
and had always had abortions procured. I was called 
to see her on May 7th, four days after the last "oper- 
ation.” Had been flowing slightly for more than twenty- 
four hours. Slight expulsive pains with more severe 
pain in the back. Os uteri soft and slightly dilated. 
But little tenderness over the pubes. Womb could not 
be felt externally. 
May 8th. Condition much the same. Foetus not 
expelled. 
May 9th. Foetus and its attachments expelled early 
this A. M. Lost considerable blood. Os well con- 
tracted and slightly sensitive to the touch. Abdomen 
not tender except to strong pressure above the pubes. 
Complains of pain in the back. Ho bleeding at present. 
May 10th. Patient easy and comfortable. Hemor- 
rhage just sufficient to color a napkin. Back-ache 
ceased. Slept well last night without opiates. 
May 11th. Complains of pain in the hypogastrium, 
with a larger show of blood. Os uteri failed to give 
the touch test of a re«ent abortion. 
May 12th. Free from pain and sitting up. 
May 13th. Found patient doing needle-work; said 
she had been doing house-work in the morning. 
May 14th. Patient makes no complaint, and attends 
to her usual household duties. TABLE OF TEMPERATURE IN CASE III/ 
Day. 
Hour. 
Thermometer. 
Pulse. 
May 7th 
4.30 P. M. 
98.50° 
90 
9 A. M. 
99.25° 
98 
“ 8th 
5 P. M. 
99.75° 
94 
9.30 A. M. 
99.75° 
108 
“ 9th 
4.45 P. M. 
99.15° 
100 
“ 10th 
9 A. M. 
98.75° 
98 
8.45 A. M. 
99° 
88 
“ 11th 
5 P. M. 
99.5° 
90 
9.15 A. M. 
99.5° 
84 
“ 12 th 
5.20 P. M. 
98.75° 
80 
“ 13th 
3 P. M. 
99° 
80 
8.45«A. M. 
99° 
88 
“ 14th 
4.30 P. M. 
99.15° 
85 
Although these observations are not sufficiently ex- 
tended to furnish us data beyond doubt, still they afford 
grounds for very legitimate probable conclusions. In- 
deed, the thermometer alone, no matter how extended 
our observations, — and opportunities are ample if phy- 
sicians will improve them, — can furnish no positive 
evidence in the case. It places one more fact 
in the array of circumstances, which, taken together, 
amount to such strong evidence of the criminal abortion. 
It is safe to conclude that these cases will give the 
following temperature indications as compared with 
dysmenorrhcea. In non-inflammatory dysmenorrhoea, 
attended with severe pain and disturbance of the circu- 
lation, an elevation of .85° above the normal heat may 
be met. 
Ill criminal abortion, in the average cases, an increase above the normal of about 1.15° will be found, as the 
maximum elevation. That the increase of temperature 
in the two eases presents the following differences, 
(«) of intensity, (b) duration, and (c) sudden variation. 
That a marked increase of temperature, all things 
being considered, is in favor of the abortion. 
That a prolonged marked elevation of temperature of 
from five to seven days is in favor of the abortion. 
That during the persistence of the morbid elevation 
of temperature, a sudden farther increase of temperature, 
in conjunction with symptoms already noted, is a strong 
indication of the criminal abortion. 
The whole subject of the temperature of the body, 
during parturition and the state of gestation, remains 
yet to be studied. We are equally in want of a knowl- 
edge of the temperature in long series of cases of 
dysmenorrheea. I know of no observations except my 
own brief notes. It is very probable, that when both 
subjects are thoroughly studied up, the thermometer in 
these doubtful cases will be a valuable instrument for 
detecting the guilty. As this crime seems to be becom- 
ing more fashionable, our means of detection ought to 
keep step with its popularity. 
As it is, I fear the crime has advanced beyond the 
means of positive detection. It is for this reason I have 
dwelt so long on so many minute points. CHAPTER III. 
ABORTION FROM MEDICATION. 
Before this crime of the period was brought within 
the strict lines of a science and art, it was perpetrated 
by means of drugs, which by direct or indirect action 
rendered the womb unable to retain its foetal contents. 
An examination of the various laws enacted by the 
different States of the United States, and by England, 
although covering the crime, however caused, shows 
that they are framed with particular reference to the 
procuring of abortion by the administration of abor- 
tient drugs. A law passed by the Legislature of the 
State of New York in 1869, and most stringent in its 
provisions, and which renders it a penal offence to pro- 
cure for a woman, whether she be pregnant or not, any 
drug capable of causing an abortion, with the intent to 
give the same, is framed with particular reference to 
the protection of the foetus from any assault upon its 
safety by means of drugs. The foeticidal drug forms 
the domestic expedient of the woman in difficulties. 
It is safe to say that every woman, married or single, 
when she suspects herself pregnant, resorts to the free 
use of drugs before she applies to the professed abor- 
tionist. Long before the days of Tofana and Brinvil- 
liers woman resorted to poison as her favorite weapon. 
The innate refinement of her nature sways her in the 
darkest moments of crime. It is for this reason that 
all that is best within her resists the gross manipulation 
of the abortionist. The opportunities a woman has to 
obtain drugs of this nature are many. I know of more 41 
than twenty-six different preparations advertised and 
sold for this very purpose. There may be many more, 
but as I do not purpose to give the names of these ad- 
vertised female pills it is not important if a few escape 
our notice. Many of the venders of these drugs make 
a direct bid for the pregnant woman by the well-known 
caution for the woman in that condition to avoid their 
use. Some of these nostrums, either from more liberal 
advertising, or from the fact that they have the power 
to, now and then, accomplish the purpose for which 
they are given, have obtained an enormous sale. 
Facts regarding the sale of these drugs in the United 
States possess peculiar interest in connection with this 
subject. I have been to great trouble since I became 
interested in this subject to obtain facts relating to this 
point. Those who are in a position to know something 
about the matter refuse to impart their knowledge. I 
have known druggists, whose information concerning it 
must have been limited, refuse flatly to tell me anything 
about it. 
I have, however, been able to put together a few fig- 
ures, — enough to startle any one who has not thought 
upon the subject. 
SALES OF FEMALE PILLS. 
For the year 1809. 
Wholesale drug stores in Syracuse, 33 gross packages. 
Retail “ “ “ “ 6 “ “ 
Wholesale “ “ “ Troy, 17 “ “ 
Retail “ “ “ “ 7 “ “ 
Total, ~63 “ “ 
These are proprietary preparations, mostly in the 
form of pills, and in the city of Syracuse embrace some 
fifteen varieties. The two cities named will aggregate 
ninety-five thousand inhabitants. The wholesale drug- 42 
stores sell their wares in the neighboring small towns. 
Without making the calculation, let it suffice to say, 
based on these figures the amount sold in the United 
States must be immense. The sum paid for these 
worthless nostrums must be near a million dollars. 
This is a large sum, but by the side of the terrible de- 
moralization to body and soul which results from this 
trade it shrinks into small consideration. The sale of 
these proprietary articles forms but a part of this trade. 
I believe there is a still larger trade in counter-prescrip- 
tions through the land. Each druggist compounds for 
himself those drugs he believes to be emmenagogue, 
and sells them to persons who call for them, at a high 
price. This is a favorite trick of the trade. I believe 
it to be a rule with them. There are exceptions, un- 
doubtedly, to this rule, but I do not know more than 
three druggists of my acquaintance in whose stores 
such a sale is impossible. The stringent law enacted 
by the Legislature of the State of JSTew York has 
placed no restraint on this demoralizing traffic. It is a 
branch of the business which appeals directly to the 
cupidity of the apothecary. He sells the prescription 
which he extemporizes for from one to ten dollars, 
according to the pecuniary standing of the applicant 
for relief. /The cool effrontery of young girls and 
women in speaking to strangers, non-professional, upon 
this most secret function of her sex is astounding. 
Having been part owner of a drug store, in a popu- 
lous city, I speak from personal knowledge. This 
fact is a striking commentary on the fashionable call 
for women physicians as the depository of the sexual 
secrets of the sex3 The apothecary usually compounds 
from two to five drugs, which he regards as emmena- 
gogue, in the form of mixture, bolus, or pill. I have 
known of perfectly inert drugs being mixed and sold 43 
to women who applied for abortifacient drugs for a 
criminal purpose. But generally druggists do not thus 
trifle with their reputations as skilful abortionists. 
The temerity with which even respectable druggists 
will sell violent and noxious drugs to women far ad- 
vanced in pregnancy forms one of the most alarming 
features of this trade. This criminal conduct on the 
part of dealers is sometimes attended with fatal results. 
In 1866 I attended a colored woman in the city of Troy, 
who died from pelvic cellulitis, after an abortion at six 
months. The mixture was procured from an apothe- 
cary at Pittsfield, Mass., where the woman had for- 
merly resided. She confessed to having drugged her- 
self for nearly three months with abortifacients. The 
woman was several years married, and childless. 
In 1860 or 1861 a case of this kind formed the sub- 
ject of official investigation near Troy. The woman, 
far advanced in pregnancy, procured a mixture of oil 
of savin, ergot, and aloes, in the form of pills, from a 
druggist. Death resulted, and a post-mortem section 
was made. The druggist escaped punishment, alleging, 
I believe, ignorance of the woman’s condition. 
The ease with which a woman with criminal motives 
obtains the means to accomplish her purpose is the 
main cause of the great trade in these drugs. There is 
not a single difficulty in her way. There are laws 
which, if enforced, will check this trade. These laws 
are not enforced, and I think for this reason: I am 
forced to believe, that in relation to this crime there 
exists a moral obliquity in all ranks of society. In 
more wealthy circles fashion regulates the number of a 
woman’s family; and the poor — their very poverty con- 
ferring on them a wealth of maternity — " banish,” as I 
once heard a poor woman call it, unborn little ones, to 
stint the cry for bread. JSTow, an ordinance for the sup- 44 
pression or punishment of an offence against society is 
enacted on the assumption that there exists in every 
community a certain proportion of law-abiding people. 
If this assumption is false — and in relation to this 
crime I fear it is — the laws are simply an array of 
words, powerless to effect their purpose. I may be 
wrong, but I believe this crime of abortion is more 
common in Protestant countries than in Catholic. 
Among the Roman Catholics the indiscreet maiden re- 
ceives her crown of motherhood. She has been taught 
from childhood to bow before the reality of an unborn 
soul. To the Protestant woman of many sects such a 
reality cannot exist. The belief finds no place in her 
heart, that the embryo of coming manhood within her 
has roused pulses of love not unmarked in heaven. 
The liability of an abortion induced medically to 
terminate fatally is largely in excess of the instrumen- 
tal abortion. This statement may be proved by the 
current criminal items of the daily newspapers. I have 
been some time in collecting twenty-one cases of death 
from criminal abortion from various newspapers. Of 
this number ten deaths.resulted from the use of aborti- 
facient drugs, five cases implicated medical men, and in 
six cases no statement was made of the means used. 
Rejecting those notices of abortion implicating medical 
men,* as very probably induced by means other than the 
administration of drugs, we have a large majority left, 
in the greater number of which it is stated drugs were 
used. Dr. Taylor, speaking of the use of medicinal 
substances as abortients, says : " They rarely answer 
the intended purpose, and when this result is obtained 
it is generally at the expense of the life of the mother.” 
(Med. Jurisprudence, p. 433, Amer. ed.) I think my 
statement of the case above is sufficiently strong, and 
that Dr. Taylor makes an assertion difficult to prove. 45 
In view of the extent of this trade and the comparative 
rarity of fatal cases known to the public as such, we 
can hardly fail to admit that abortion from medication 
must be practised with success. 
An abortion from the use of drugs is more difficult 
of detection from the spontaneous abortion than one 
from instrumental interference. When the abortion is 
the result of the use of noxious drugs it simulates the 
abortion from natural causes. The series of morbid 
acts, which stand in the relation of sequence to the 
abortifacients, slowly culminate. The acme is abortion. 
The participation of the uterus in these systemic 
changes must be, partly at least, those which take place 
in the abortion from natural causes. It is for this 
reason that those symptoms which stand out in such 
bold relief in the instrumental abortion are wanting in 
these cases. So far as the uterus alone is concerned, its 
condition must be nearly alike in both the spontaneous 
abortion and one from the effects of drugs. In both 
the foetus is expelled non-viable as a rule. The viabil- 
ity of the foetus is destroyed, not from any direct action 
of the cause, but for the same reason that rendered the 
womb untenable. 
Two conditions may become factors in isolating this 
class of abortion from those, the result of natural, slow- 
acting causes, (a) time, and (b) any peculiarity in the 
action of the exciting cause. 
(a.) Time for the exciting cause (the abortifacient) 
to manifest its individualities. It is evident that the 
symptoms which result from the criminal use of a drug 
would loom prominently in the beginning of the morbid 
acts in contradistinction to the insidious approach and 
gradual climax of the spontaneous abortion. 
(5.) The action of any drug or combination of drugs 
must have its peculiarity of action more or less marked 46 
upon the group of symptoms which result from its use: 
Abortifacients may be divided into three classes: — 
(a.) Those which act directly on the womb. 
(b.) Those which act reflexly by the irritation of 
some usually contiguous organ. 
(c.) Those which are combined pharmaceutically and 
unite the action of (a) and (b). 
Our study of criminal abortion from medication will 
turn on the pharmacodynamics of the drug employed. 
To base its diagnosis on any other ground would lead 
to error, (a.) Those abortifacients which act directly 
on the womb and render it untenable are few in num- 
ber, and some of them of doubtful power. It will be 
important for us to inquire, when, and to what extent, 
is the womb capable of this direct stimulation of its ex- 
pulsive power. Let us take ergot as the type of its 
class. Its physiological action on the lion-striated 
muscular fibre is the source to which we now refer 
what was formerly regarded as its elective power on 
the uterus. There are well-grounded doubts as to the 
power of ergot alone to accomplish an abortion in the 
very early months of gestation. The uterine mechan- 
ism subject to the excito-motor action of ergot is defi- 
cient in those months. The unimpregnated womb is 
slow in its expulsive movements. Its capacity for 
motor efforts is limited by its state of non-develop- 
ment. Many observers have expressed their doubts of 
the ability of ergot to cause abortion in those months; 
Warner, Villineuve, Chatard, and others. (Heal, Re- 
searches, etc. Pereira, Mat. Med. vol. ii., p. 68.) 
I am more inclined to ascribe any influence it may 
have on the hemorrhage of an unimpregnated womb to 
its action in lessening the calibre of uterine blood-ves- 
sels,— the analogue of its action in hemoptysis, — than 
to any power it may have on the muscular structure of 47 
the organ. The womb, however, at any period of its 
functional existence being a muscular organ, when re- 
flex irritability is once established, ergot, by almost 
universal admission, will hasten expulsive efforts in the 
impregnated womb. 
It is our purpose to study the criminal use of the 
drug. It is • doubtful if there is an intelligent woman 
in any but the remotest places but understands that 
ergot " will bring on pains.” The drug, therefore, gen- 
erally plays an important part in the abortion. There 
is more science and skill shown in the management of 
the drugging than is usually supposed. After pills 
and teas and foot-baths, including the gin-bottle, ergot 
is almost sure to be called upon to perform its office. 
The study of the detection of the administration of 
ergot will embrace many points. Ergot is a promoter 
of neurodynia. Although I have not seen this action 
of the drug referred to by any author I have yet mj3t 
with, still I believe it is a common elfect of its exhibi- 
tion. This ergot-neurosis occurred three times in a 
limited number of cases, and in myself during an ex- 
periment. It may be difficult to isolate this condition 
of the nervous system from what may be called the 
normal neuralgia of abortion, unless we are aware of, 
what may on more extended observation prove the rule, 
that the neurodynia in question attacks nerves not usu- 
ally liable to pain during labor, or an abortion. In- 
deed, pain in the track of nerves is what we might ex- 
pect from its physiological action. I regard it as the 
result of a nerve-ansemia. Romberg says, " It seems as 
if pain were the prayer of the nerve for healthy blood.” 
This idea of deficient blood supply holds good in many 
forms of neuralgia (Dr. C. Ilandfield Jones, Clinical 
Obs. on Functional Nervous Disorders, Amer. ed., p. 
40), and applies with equal force to the neuralgia of 48 
ergotism. The action of the drug on non-striated 
muscular fibres of minute arterial coats leads to that 
anmmic condition of the nerve which causes pain in its 
trunk and peripheric terminations. In the cases ob- 
served by me this neuralgic action of the drug seemed 
to have a selective power over the nerves of the ex- 
tremities. I think this neuralgia of ergotism will ex- 
plain many of the phenomena attending the administra- 
tion of ergot in parturition. Among these are the 
lingering uterine pains unattended by contraction of 
the organ, after the ergotic contractions have ceased, 
and an intense neuralgic pain, which is often observed 
to prelude the expulsive efforts of the womb. Another 
condition following its use in labor, and which is char- 
acteristic* is the excruciating pain attending uterine 
ergotic contractions, altogether out of proportion to the 
power of the expulsive efforts. 
•Pain in the spontaneous embryonic abortion is the 
symptom which preludes and accompanies the expul- 
sive stage of the accident. So rarely is it present, ex- 
cept as a sense of uneasiness, at any other period, that 
we may regard this as a rule. I would except from 
this rule ovarian irritation and slight pain which is so 
often present when any undue influence is exerted on 
the reproductive organs of woman. Cazeaux (Obstet., 
Amer. ed., p. 326) tersely calls the predisposing causes 
of the spontaneous abortion the " slow-acting causes.” 
We should therefore constantly have our attention 
alive to the fact that severe uterine or ovarian pain 
taken singly is rarely seen in abortions from natural, 
slow-acting causes, in any but the later stages of the 
process. We then find that in the liability of ergot to 
excite uterine or ovarian neuralgia, independent of any 
power it may have to cause expulsive efforts in the 
womb, we have sure means of detecting its administra- 49 
tion. This neurodynia, to be of any detective value, 
must be present at a period of the abortion when the 
expulsive pains would not, judging from the condition 
of the os, be present. If in addition to this condition 
we take into consideration the possibility of the drug 
causing neuralgia of the extremities, of the face or 
scalp, we have presumptive evidence of its administra- 
tion. I have, however, hardly been able to make out a 
case; but I can make the evidence still stronger. 
Another means of recognizing ergotism is the persist- 
ence of its effects. Trousseau and Maisonneuve no- 
ticed (Bull, de Therap. iv., 106) as a uniform symptom 
of ergotism, a dilatation of the pupil. It began from 
twelve to fourteen hours after administration and con- 
tinued for several days. I have not observed this my- 
driatic effect of the drug from its legitimate use, still it 
should always be looked for, as its criminal use implies 
the conditions essential to the development of mydri- 
asis. These conditions are too large and too frequent 
doses. Ergot lowers the rate of the pulse to a remark- 
able degree. Dr. Quinton Gibbon, of New Jersey, 
found his pulse decline from seventy to fifty-five beats. 
(Stille, Therap. ii., p. 723.) Arnal found that this 
action of the drug commenced within an hour, and 
lowered the pulse from eighty-four to sixty-two, and at 
an average rate of eight beats in a minute. (Bull, de 
Therap. xxxvi., 5-34.) Dr. Hardy observed that in 
the parturient female this effect took place in from fif- 
teen to thirty minutes, and sometimes continued for 
several days. (Dublin Jour, of Med. Sci., xxvii., 
225.) This remarkable action of ergot upon the pulse 
isolates the drug from all others at all likely to be em- 
ployed for a criminal purpose. This depressing action 
on the heart is made evident at the time, when, from the 
nature of things, we should expect to find marked ac- 50 
eeleration of the action of the heart. If, then, in a case 
of confessed pending abortion, or in a case in which the 
attempt is made to conceal the abortion under the mask 
of dysmenorrhcea, we were to find a pulse beating at 
fifty-five to sixty-five, it would be a just cause for a 
careful scrutiny of the case. 
Another means of detection of the administration of 
ergot is the use of the thermometer. The pulse-beat 
ratio is lowered j)ro rata. In some experiments upon 
myself, to test this point, I found the effect of ergotism 
upon the temperature marked. Drachm doses of Til- 
den’s ext. ergot were taken at irregular intervals, as 
business would permit, and the temperature taken with 
the bulb under the tongue, the scale being read with a 
mirror. The mean of thirty-five observations before 
taking the ergot was 98.158° F., which was assumed 
as the healthy standard; the mean of eighteen observa- 
tions during ergotism was 96.012°. The thermometer 
ranged slightly lower on the first day than on the two 
succeeding days. Two days after, making the fifth 
day from the beginning of the experiment, the instru- 
ment showed a mean range of 97°. Ten drachms of 
the ext. ergot were taken during the experiment. 
And lastly, for the detection of use of ergot in the 
criminal abortion, we have the sphygmograph. When 
we take into consideration the marked power of ergot 
over the heart and its persistence of effects, we have in 
this instrument an unerring means for the detection of 
ergotism. The pulse-tracing after ergot is so marked 
that when the sphygmograpliic pulse-wave is seen, it is 
simply a question of some grave pathological condition, 
or of ergotism. The pulse-trace after the lapse of 
from one to twenty hours following a dose of ergot 
presents the following features: (a) diminished systol- 
ic distention, (b) increased arterial pressure, (c) irreg- 51 
ularity in the heart’s action as shown in the unequal 
value of the primary wave (Figs. 3, 4, 6), (d) the flat- 
tened instead of the acute apex of the normal pulse- 
wave, — the senile pulse of Marey, (e) a loss of tricro- 
tism with a tendency to dicrotism and the monocrotic 
type. The flattened apex indicates, according to Mar- 
ey, a pathological change in the arterial walls; but in 
these cases it does not have that significance. The age 
of the subject would prevent that explanation being 
given; the gradual return to the normal sharp apex 
would demonstrate that it depended .on some other 
cause. I explain it as the result of a profound impres- 
sion on the nervous system. It is also found in the 
pulse-trace of the insane. These remarkable changes 
in the pulse occur in less than an hour after taking a 
dose of ergot; and as shown in Fig. 9 there is the first 
tendency to a normal tracing after thirty-nine hours 
and fifteen minutes. Dr. John Man Duyn, of this city, 
kindly took the tracings for me. The subject was my- 
self. Want of space prevents my giving the details 
of the experiment. 
Fig. 1. — Standard tracing in health, taken twenty-three hours before the experiment. 
Fig. 2. — One hour and forty-five minutes after taking two drachms of Squibb’s fluid extract 
of ergot. 
Fig. 3. — Two hours and fifteen minutes after. 52 
jijq 4 Two hours and thirty minutes after the first dose, and fifteen minutes after taking 
one drachm of ext. ergot. 
Fig. 5. —Two hours and forty-five minutes after first two dr. 
Fig. 6. —Three hours after. 
Fig. 7. —Eleven hours after. 
Fig. 8. —Eighteen hours after.* 
Fig. 9.—Thirty-nine hours and fifteen minutes after. 
Cotton-root (Grossypium herbaceum) is the next drug 
in common use of this type of abortifacients. A drug- 
gist in extensive trade informed me that the sales of 
ext. cotton-root had quadrupled in the last five years. 
It is purchased very extensively by small miscellaneous 
country merchants, who always have the extract among 
their stock of drugs. The use of cotton-root and its 
extract is confined solely to its supposed emmenagogue 
and abortifacient powers. The operation of the drug 
as a parturifacient, which Dr. Shaw of Tennessee and 
* There are intercurrcnt causes of the lessened value of the primary wave in this tracing. It 
is given here, as it distinctly shows the ergotic pulse. 53 
others ascribe to it (Jour, of Mat. Med. iii., 31), indi- 
cates that it has a selective power over unstriped mus- 
cular fibres like the ergot. I have no experience with 
it. Physicians who have used it tell me it has no 
excito-motor power over the uterus; others whom I 
know say it has a marked influence over the expulsive 
action of the womb during labor. 
Dr. Bouchelle drew attention to the properties of the 
cotton root in 1840, only as an emmenagogue however, 
and stated that the slaves of the South used it to pro- 
duce abortion, which it did kindly, and without seri- 
ously affecting the general health. (Loc. cit.) Since 
that period the drug has been coming into more general 
popular use. It has seemed to work its way into gen- 
eral favor on its own merits. If it has any powers as an 
abortifacient the detection of its administration is diffi- 
cult, with our knowledge of its peculiar action. • If 
what we read of it is true, it makes great dynamic power 
under remarkable mildness of operation. In order to 
test any poisonous effect the drug may have when its 
use is pushed to extremes, I injected two and one-half 
drachms of Tilden’s ext. under the skin of a dog three 
months old, weighing about three pounds and a half. 
The injections were in lialf-drachm doses, under the 
skin of the abdomen, at the following intervals: 10.43 
A. m., 11.30 a. m., 12.45 m., 2 p. m., and at 5.15 r. m. 
The temperature of the rectum, taken just before the 
first injection, was 98.8°, and the respirations twenty- 
eight in a minute. The effects resulting were as fol- 
lows: at 11.50 the temperature of the rectum was 
99.4°, and the respirations thirty-six, and the dog ap- 
peared well and playful. At 1.45 p. m., temperature 
101.6°, and the respirations forty-four, appearing drow- 
sy, stiff in the hind legs, and the abdomen tender on 
pressure, which I ascribed to the punctures of the syr- 54 
inge. At 2.10 p. m. breathing labored, condition other- 
wise unchanged. 3.30 p. m., lying down, disinclined to 
exertion, drowsy but not sleeping. 4.20 p. m., temper- 
ature 102.5°, respirations forty-eight, thirsty and un- 
easy, eyes dull and heavy, breathing labored. 6 p. m., 
sleeping soundly, with hard, long respirations, tempera- 
ture 103.8°. 9 p. m., still sleeping, but on a smart 
shaking roused up and drank freely of water, great 
thirst. There has been no effect on the pupil at any 
time. The next morning, at 7 A. m., the dog was play- 
ful and eat a hearty breakfast, and appeared well during 
the day, the temperature having returned to 99.4° at 
noon. In the evening the little animal made his escape 
from my inhospitable office, — the result apparently of a 
carefully matured plan. I questioned a girl, who ad- 
mitted its use in table-spoonful doses every two or three 
hours, with no effect, as she stated, except to cause her 
to sleep a great share of the time. She kept up the 
use of the drug — the extract was used—for over a 
week, and towards the latter part of her experiment 
she had headache, pain in the back, frequent desire to 
urinate, attended with burning pain. 
I know of but one effect attending its administration 
which would lead us to suspect its use, — the operation 
of the drug as a narcotic when freely used. Pending 
a criminal abortion, when there is any degree of ner- 
vous disturbance, as there usually is, there is great 
sleeplessness. When there is also fear of detection 
there is a restless vigilance, which is naturally an enemy 
to sleep. If then the cotton was used freely, we would 
have a heavy, drowsy condition, hard to explain, espe- 
cially as the subject would deny having taken any medi- 
cine, in all probability. It would be well, under such 
circumstances, to direct our attention to the general 
features of the case, surroundings, etc., to which I hav' 55 
repeatedly referred. Owing to the extensive use of 
the drug among people criminally disposed it is impor- 
tant that it be more carefully studied. 
Extract of cotton-root responds to the following 
tests, and although rough in their character, still the 
tests are so ready of application that there would be 
little difficulty in detecting the extract in the contents 
of a suspicious bottle in the possession of the patient. 
Its detection is further simplified by the fact that the 
extract is used very rarely in combination with any 
other supposed abortifacient. 
(a.) To a; weak solution permanganate of potash ext. 
c. added guttatim turns to a light-brown color, and in 
ten or twelve hours throws down a brown flocculent 
precipitate. 
(b.) Creosote added guttatim to dilute ext. c. forms 
a cloudy yellow solution, throwing down on adding 
water largely. 
(c.) Ext. c., to which hydrochloric acid is added 
(gtt.), forms a pinkish solution: 
(d.) Sulphate iron, strong solution, and ext. c. forms 
an inky solution, which clears up to a bright red on 
adding hydrochloric acid. 
(e.) Solution sulphite soda and ext. c. forms a red 
solution, which clears up almost colorless on adding 
acetic acid. 
(/.) Solution of sulphuret of potash and ext. c. 
forms a red solution, which, on the addition of sulphu- 
ric acid, causes a pinkish flocculence, which quickly sep- 
arates into white below and red above, the white floccu- 
lence precipitating to the bottom of the test tube after 
an hour or two, the red suspended at the surface, an 
almost colorless fluid intervening. 
These tests have been repeatedly verified. Various 
fluid extracts, especially those obtained from roots, 56 
have been subjected to the same reagents and have 
failed to respond in like manner. The test (/) seemed 
to be the most characteristic. No other extract treated 
in the same manner gave a reaction at all liable to be 
mistaken for it. CHAPTER IY. 
REFLEX ABORTTFACIEN To. 
Reflex abortifacients (b), which act as abortifa- 
cients by reflex irritation from a (usually) contiguous 
organ, embrace all those agents, which, by irritation of 
the pelvic viscera, stomach, or intestines, or by a toxical 
effect upon the system, induce changes in the circulation 
or innervation of the womb, and render it untenable 
of its foetal contents. 
Aloes. — The drug which may stand as the type of 
the reflex abortifacient, is aloes. It is rarely given 
unless in combination. It forms a leading ingredient 
in all the emmenagogue pills sold as proprietary arti- 
cles. I believe that if those nostrums known as female 
pills ever succeed in causing an abortion, it is through 
the abortifacient power of the aloes. The dose of these 
pills is uniformly large; and when taken in the full 
dose stated in the printed directions, a powerful cathar- 
tic effect is produced. The dose is repeated from two 
to three times a day, and the use of the nostrum is con- 
tinued from one to two weeks. This is the manner in 
which they are employed when the intent is criminal. 
The result of this excessive medication is a profound 
impression upon the circulation and innervation, espe- 
cially of the pelvic contents. This hyper-catharsis 
causes great tenesmus, and hemorrhoids, syncope, and 
trembling limbs. In one case which came to my knowl- 
edge, the poor, misguided child — for she'was but little 
more in years — took repeatedly doses of fifteen pills, 58 
of the kind called "Sir James Clark’s,” in her des- 
perate anxiety. The only result was hyper-catharsis 
and extreme prostration, and months after, her health 
was not restored. Disastrous as were the effects, the 
case presented a strong comic element. The girl was 
not pregnant, and all her pain was the result of a false 
alarm. 
We cannot gauge the action of aloes as an abortifa- 
cient by the effects produced by its legitimate use. 
When emmenagogue pills, composed largely of aloes, 
are used with a criminal purpose, they are used to the 
degree of hyper-catharsis. This condition is prolonged 
for days and even weeks. When a woman has the 
courage to persevere in this, it is not a mystery that she 
aborts, but that any foetus should escape such a de- 
termined assault with this weapon. 
There are anatomical reasons why aloes used in this 
manner should prove an abortifacient. Aloes is a 
powerful stimulant of the lower bowels, especially of the 
rectum. It also possesses this peculiar trait; stimulant 
in its general action, rather than sedative or depletory, 
the circulation being accelerated.* It is not difficult to 
account for the symptoms resulting from its prolonged 
use. The excessive tenesmus and heat and fulness at 
the anus are the result of rectal engorgement. The 
middle hemorrhoidal artery, and the uterine and vaginal 
arteries arise from the anterior trunk of the internal 
iliac. In addition to the juxtaposition of these parts 
they have a common blood supply. It is difficult to 
conceive how prolonged hypermmia of the walls of the 
gut could occur without the womb and vagina partak- 
ing of this state of blood stasis. This is theoretically 
why aloes is an emmenagogue, as' affirmed by the old 
writers. Hot only the direct action of the drug, but 
* Stille, Therap. & Mat. Med., n., p. 570. 59 
the resulting tenesmus, must cause an increased flow 
of blood down the trunk of the internal iliac, of which 
the womb, vagina, bladder, and rectum receive their pro 
rata share. Without taking into consideration the 
theory, that inhibitory nerve action may prevent the 
sexual organs participating pro rata in the rectal hy- 
persemia, we have just anatomical reasons for regarding 
the drug as imminently dangerous to the safety of the 
foetus. 
Considered in its reflex relations to the uterus, the 
drug plays an important part. The extreme of irri- 
tation, resulting from its prolonged use, is the very con- 
dition necessary to excite reflex motor action in neigh- 
boring organs. In the relation of the rectum and uterus 
we have great intimacy of nerve connection. Although 
intimate nerve relation is not necessary to the production 
of reflex motor action, still in this case I claim for it 
consideration as an important factor. The hemorrhoidal 
plexus of nerves has a ganglionic connection with the 
uterine nerves. The motor stimulus from the rectum 
can be reflected off from the ganglia of the inferior hy- 
pogastric, and transferred to the uterine plexus without 
the intervention of reflex power from the spinal cord.* 
In addition to this, the spinal cord must bo allowed its 
share as a transferrer of irritation from organ to organ. 
Clinical observations regarding the use of the drug 
establish the fact of its great power over the reproduc- 
tive organs of woman. And even over those of man it 
has been observed to have a marked influcnce.f It. is 
more than probable that the well-established value of the 
drug in amenorrhcea is owing to the fact that the ovaries 
are included within the circle of reflex irritation. The 
pregnant womb is then subject to two conditions, which 
* Dr. Rutherford on Experimental Physiology, London Lancet, Aug., 1871, Amer. Ed. 
f Stille, loc. cit. 60 
render it highly probable that if these conditions are 
prolonged, abortion will result, — engorgement from its 
common blood supply with the rectum, and motor action 
derived reflexly from ganglia, and from the cord. I at- 
tribute then to aloes great power as an abortifacient 
when used with a determination to accomplish a criminal 
object. Notwithstanding the fact that the profession 
are disposed to regard aloes as comparatively innocent, 
still from the large use made, popularly, of female pills 
composed chiefly of aloes, I believe people give due 
credit to the drug. 
I will now consider the evidence which would lead to 
the presumption of the administration of aloes, or of 
aloetic compounds. It will be necessary, in order to 
render the signs of any detective value, that the crimi- 
nal use of the drug be continued to the inception of the 
abortive process; and there would be thus grafted upon 
the symptoms of a pending abortion the signs of exces- 
sive aloetic purgation. I think I am safe in saying, 
that when a woman resorts to abortifacients on her own 
unaided advice, the use of the drug is continued up to 
the time of the resulting abortion. This is quite evi- 
dent if we take into consideration the impulsive and 
impatient nature of a woman in “ trouble.” It is a curi- 
ous fact in the history of abortifacient drugs, that, with 
the exception of Gossypium, they all possess a strong 
individuality. Aloes is a marked example of this. 
The detection of the criminal use of the drug turns 
upon three points: (1.) The effects of the drug upon 
the system at large. (2.) The local evidence of its 
criminal use. (3.) The modification of the symptoms 
of the resulting abortion. 
(1.) The effects of aloes upon the system at large.— 
The drug is an anomaly among evacuants. Its action 
is stimulant to the circulation, rather than depletory. 61 
This is indicated by increased heat of surface and 
quickened pulse. This action is also present in the large 
intestines, as a sensation of heat and fulness along the 
track of the colon. The urine is scanty and high-col- 
ored. These symptoms will often attend its legitimate 
use. Excessive aloetic purgation is attended with heat 
and tenderness along the course of the colon, more on 
the left side than the right, the urine still scanty and 
high-colored, oftentimes with marked acceleration of 
the pulse, the result apparently of intestinal hyperaemia. 
The face is inclined to flush, not to blanch and shrink, 
as in the case of the drastic or hydragogue cathartics. 
There are transient shooting pains, and tenderness over 
the region of the liver, with the sensation of heat and 
fulness. 
(2.) The local evidence of its criminal use. — From 
the marked impression upon the circulation and inner- 
vation of the large intestines, it is apparent there would 
be local evidence of its excessive use. One of the 
most prominent results is the torturing tenesmus, 
which I saw in 1867 occurring in a woman whom I had 
attended in two former abortions, during my student 
life, and which she denied having procured in any 
manner. On the occasion alluded to, she told the truth 
by way of variety, as Gil Bias has it, and confessed 
having made use of female pills, composed largely of 
aloes, for over ten days. Such was the torment from the 
tenesmus that she could lie in one position hardly a mo- 
ment. She had constant calls for the vessel, passing 
nothing but a scanty bilious evacuation streaked with 
blood. She said it was nearly two days since she had 
taken any of the pills. This would be characteristic of 
the drug, as its action is slow but prolonged. There is 
pain in the back, heat and fulness in the rectum and 
anus, and in the case referred to above there was ten- 
derness on pressure in the hypogastric region. There 62 
may be frequent desire to urinate, dependent upon re- 
flex strangury. A symptom always present is the 
marked and peculiar odor of the aloetic dejection. 
Unless great precautions are taken as regards ventila- 
tion and cleanliness, the strong odor of the stools will 
linger for days. This is more marked in the case of 
small bedrooms, hung round the walls with wearing 
apparel, as is often the case, the fabrics holding the ef- 
fluvium for several days. 
(3.) Modification of the symptoms of the resulting 
abortion. — We may expect some aid in the detection 
from the prolonged action of the aloes. After the ex- 
cessive use of the drug, purgation, attended with the 
peculiar odor and tenesmus, will continue from twenty- 
four to thirty-six hours after the exhibition. We may 
expect in those cases in which aloes has been mainly 
instrumental in the abortion, the following symptoms: 
The usual symptoms of a pending abortion, plus the 
presence or history of tenesmus, and a remarkable ca- 
thartic action of the bowels, with aloetic odor. Scanty 
and high-colored urine, uneasiness or pain and heat in 
the region of the liver, and also along the track of the 
descending colon, and a presence or history of in- 
creased heat of surface and accelerated pulse, in place 
of the languor and depression which anticipates the 
innocent spontaneous abortion. 
If there is any tendency to hemorrhoids, aloes will 
quite surely renew them. The existence of piles, in an 
active state of flux, concurrent with abortion, would be, 
in my opinion, a just reason to scrutinize the circum- 
stances attending the case. Fluid, or partially fluid, 
dejection streaked with blood, would also cast doubt 
upon its innocence. The aloetic odor on first entering 
a sick-room ought also not to pass unnoticed.* 
* Dr. Greenkow speaks of the diuretic action of the drug. (Lond. Med. Gaz. xix., p. 
270.) In my own experiments, its effect upon the kidneys was that stated in the text. 63 
Black Hellebore (Helleborus niger.) — This drug is 
not in popular use in this country as an abortifacient. 
It is referred to here as it may be used criminally by 
druggists or medical men. I am inclined to assign to 
hellebore no more emmenagogue power than any irritating 
cathartic possesses. Like aloes, it exerts a forcible influ- 
ence over the uterus by the reflex irritation it excites. 
Croton oil, gamboge, colocynth, elaterium, and other 
drastic purgatives, may be used for this purpose. As 
the symptoms by which their use may be detected de- 
pends on their cathartic action, they will be considered 
together. Any cathartic drug may also -be used crimi- 
nally. I know of one case in which a young woman of 
bad reputation used a decoction of pink and senna; it 
produced vomiting, great pain in the abdomen and 
catharsis, and, strange to say, was followed by abortion; 
she was advanced five months in pregnancy, and claims 
she used no other means. It is thus shown that women 
often exhibit a great variety of resources, and any one 
of the cathartic drugs in common use may be used 
criminally. From our knowledge of the action of re- 
peated doses of powerful cathartics, we can readily see 
how an abortion induced in this manner would simulate 
in a marked degree the spontaneous abortion from slow- 
acting causes. ISTo cause can act so powerfully, within 
the limit of ordinary safety, as prolonged catharsis. 
The exhaustion, the pallor, and the debility would all 
tend to corroborate the woman’s statement if she alleged 
an abortion was habitual with her. But, to offset her 
assertion, there would be facts revealed by a careful 
examination of the symptoms and history of such a case. 
There would be tenderness of the abdomen; persistent 
borborvgmus; a periodical laxity of the bowels, result- 
ing from a constant tendency of the bowels to constipate 
after the over-stimulation of the purgative, and being 64 
spurred into action again by a repetition of the cathartic 
dose. There would be wandering pains in the abdomen 
not at all after the character of the pains of labor. If 
the hyaragogue cathartics were used, there would be 
scanty urine, a blanched and pinched look about the 
face, thirst without fever, a history of recurring fluid 
evacuations, with intervals of freedom from catharsis, 
and also other features so often referred to in these 
pages as common to all cases of criminal abortion, 
however caused. 
As hellebore has gained a reputation for efficacy as 
an emmenagogue, and is generally so regarded by 
druggists, and also by women who are disposed to seek 
for foeticidal drugs, it may be proper to say a few words 
in regard to its special detection. Small doses would 
cause increased peristaltic motion of the intestines, fol- 
lowed by heat and fulness of the pelvic vessels. In one 
case in which the tincture of black hellebore was pre- 
scribed in combination with ergot by a druggist, and 
used with foeticidal intent, the woman informed me that 
she had repeated painful motions, with vomiting on the 
second day, tenesmus, heat through the hips, and bearing 
down. She abandoned its use, from the great pain and 
sickness of the stomach. No abortion was produced. 
Dr. Massey, of Nottingham, Eng., relates an interesting 
case of over-dose of hellebore. A teacupful of infusion 
of the strength of one and a half ounces of the root to 
twelve ounces of water, was taken in the morning. It 
produced pain and pricking in the tongue, fauces, and 
throat. There was a painful sense of constriction and 
strangury of the throat, pain at the epigastrium, and 
very violent sickness; much viscid mucus was voided 
from the mouth. The eyes were sunk; there was ex- 
cessive prostration of the strength; discoloration about 
the eyelids. The extremities were cold, and the general 65 
surface was bedewed with a cold clammy sweat. Pulse 
varied from thirty to fifty beats in a minute, very small 
and at times scarcely perceptible. * The symptoms fol- 
lowing the use of hellebore, in an alleged abortion from 
innocent natural causes, would probably be sickness and 
pain at the stomach, large fluid evacuations attended 
with much pain, heat, and bearing down in the rectum 
and vagina. Dry throat, sunken eyes, and a pinched 
appearance of the face. It is possible, of course, that the 
dose may be so small as not to produce any marked 
symptoms, but in such a case it is doubtful if an abor- 
tion would result. An abortion from cathartic medi- 
cation is, if it were possible, more the result of violence 
and shock than an abortion from instrumental inter- 
ference. 
Savine (Juniperus Sabina?). — We have in this po- 
tent drug a twofold abortifacient. Whenever a criminal 
use is made of this drug, it is certain that the maternal 
life is in danger. 
The abortifacient power of savine seems to depend 
on two conditions: (a) its power to cause turgidity of 
the viscera of the pelvis ; (b) its exciting action on the 
rectum and bladder, causing it to act reflexly on the 
womb. Its toxical effects being characterized by pro- 
found insensibility, in their more marked form, from 
their very nature, can have but little, if any, influence 
in the expulsion of the foetus. According to Letheby, 
it has a specific action on the vessels of the lower 
bowel. This action also extends to contiguous organs.f 
Yogt says that it produces an apoplectic condition of 
the foetus. Its toxical effect, so far as it is limited to 
producing undue engorgement of the venous system, is 
highly favorable to an abortion. If urged beyond this 
* London Lancet, Amer. reprint, 1856, n., p. 337. 
t Lancet, 1845, n., p. 142, Amer. reprint. 66 
point, the drug proves fatal, without inducing an abor- 
tion. From its use, in dangerous doses, we may learn 
enough of its action to give us presumptive evidence 
of its administration. Facts derived from this source, 
however, would still leave us in doubt as to the evi- 
dence of its criminal use, within the limits of safety. 
Doses of from fifteen to twenty drops of the oil — and 
to a delicate woman such a dose would be highly dan- 
gerous — may be expected to cause the following symp- 
toms: Violent pain in the abdomen, vomiting, and a 
powerful cathartic action, with tenesmus, strangury, 
heat and burning in the stomach, bowels, rectum, and 
anal region; intoxication, flushed face, severe headache, 
with a sense of constriction in the temporal region. 
Purging does not always follow its use in dangerous 
doses.* The drug is highly stimulant to the glandular 
system, so much so that salivation is often present.f Its 
odor is clearly evident in the urine, which is increased 
in quantity, and passed more frequently. It operates 
as a specific excitant and irritant of the kidneys, and, 
accordingly, symptoms referred to these organs will 
become prominent after its use.J The pulse is quick- 
ened, skin hot and dry. A contracted pupil is gener- 
ally present during insensibility. § This symptom may 
be present under a smaller dose than is usually followed 
by coma. Distressing hiccough is very generally 
present. Tenderness, on pressure, all over the abdo- 
men, throbbing of the carotids, severe headache and 
backache are present. The vomited matter in savine 
poisoning is often of a green color, from the presence 
of altered bile. The powerful terebinthinate odor is 
always present. I have repeatedly detected it after the 
legitimate dose of six drops. The drug, even in moder- 
* Taylor on Poisons, p. 501. 
$ Pereira, Mat. Med., n., p. 182. 
§ Lancet, n., p. 142, Amer. ed. 
f Loo. oit. 67 
ate doses, has a marked action on the reproductive 
organs of woman. In an obstinate case of suppressed 
menstruation, eight drops ter die caused heat and ful- 
ness in the parts, and arrested a leucorrhcea, which, 
however, returned after the employment of savine was 
abandoned. Its wonderful and apparently direct action 
on the womb has led Dr. Metsch to prescribe the drug 
in the prophylactic treatment of whabitual” disposition 
to abort, from diminished vitality of the uterine sys- 
tem.* 
These marked and dangerous symptoms following the 
criminal use of the drug are rare. When blood is 
present in the stools, and drowsing comes on, the case 
is almost certainly fatal, and thus, so far as one phase 
of the crime is concerned, would be rarely met with. I 
know of but one recorded case of recovery, that of Dr. 
Hinds, in which the case terminated in dangerous peri- 
tonitis.f 
In those cases in which death is threatened from the 
use of the drug, it is highly probable that the physician 
would be quickly informed of the nature of the poison, 
by the patient, if not insensible, or by the friends; as sui- 
cide forms no part of the plan. Those cases then, in 
which the criminal use of the drug is restrained within 
the limits of safety, will particularly interest us. I 
made a series of experiments to ascertain the symptoms 
following different doses of the oil: — 
Experiment 1st.—After taking a tracing of the pulse 
at 2 P. M., a dose of 10 minims of oil of savine was 
taken at 2.10; in ten minutes there was heat and flush- 
ing of the face,' a circumscribed pain in each temporal 
region, heat in the stomach; ideas slightly confused 
as if from several drinks of whiskey; flatulence. At 4 
* Zeitschrift fur Geburtkunde; Braith. Ret. xxi., p. 360. 
f Times and Gaz., Nov., 1857, p. 524. 68 
P. M., 5 minims of oil were taken. The peculiar odor of 
the drug was now very evident in the breath. Odor 
was also present in the urine. At 8.55 P. M., 10 minims 
of oil were taken; in five minutes there was present 
the circumscribed pressure sensation in each temporal 
region, painful heat, and fulness of the vessels of the 
face, confusion of ideas, flatulence, headache, rumbling 
in the intestines, great restlessness during the night, 
with a most severe headache the following day, with 
slightly congested conjunctivae. The odor of the oil 
was freely exhaled by the skin, the night-shirt and sheets 
smelling strongly of the drug in the morning. 
Experiment 2d. —15 m. of ol. savine were taken 
at 10 A. M.; at 10.20 a stimulant effect upon the brain, 
evidenced by semi-intoxication; sense of painful stricture 
over the temples, pulse beating with great force, heat 
and weight at stomach. 11 A. M., intoxication nearly 
passed off*. Flatulence, with an intense taste of savine, 
rumbling of intestines, headache, urine passed twice in 
an hour, slight increase in amount, and savine odor 
strong. 1 P. M., repeated dose of 15 m. ol. savine; 
1.20 P. M., intoxication more marked than in the morn- 
ing, as also sense of stricture, and pain in head. 10.40 
P.M., nausea, and pain in the umbilical region, face pain- 
fully flushed and congested. At 2.30 P. M., a free evac- 
uation of the bowels occurred, attended with great pain 
in the track of the colon, and burning at the anus. 
Urine passed in small quantities, but frequently high 
colored and highly charged with savine odor. 3.10 
P. M., urine passed frequently, but no strangury; slight 
nausea, and pain in bowels, pulse full and strong, 
intense headache, conjunctive congested. Temperature 
of body 100°.2. 3.30 P. M., above symptoms still 
present; another evacuation of bowels. 5 P. M., 
headache not so severe; nausea and pain ceased. 8 
A. M., passed an almost sleepless night; severe head- 69 
Fig. 1. — Trace taken ten minutes before the savine. 
Fig. 2. — Trace twenty minutes after fifteen m. of ol. savine. 
Fig. 3.— Trace fifty minutes after. 
Fig. 4. — Six hours and forty minutes after first dose, and four hours and fifty minutes after 
taking five m. of ol. savine.* 
Fig. 5. — Twenty minutes after third dose, ten m. of ol. savine. 
Fig. 6. — One hour and twenty-five minutes after last dose. 
Fig. 7. — Twenty-seven hours and forty minutes after last tracing. 
ache, appetite poor, nausea after breakfast. 10 P. M., 
severe headache throughout the day. Ho evacuation 
of bowels. Odor of savine still present in urine. 
Sphygmographic characters of the pulse. — Great in- 
crease in heart force, and lessened arterial tension, indi- 
cating extensive venous engorgement, are the marked 
features, which, like the head symptoms, will persist for 
twenty-four hours or more. The heart systolic power 
is beautifully demonstrated in Fig. 6. Crotism not 
changed from the normal. 
Action upon the system of man. — The following may 
be safely given as the action of savine: — 
* Taken after walking one and a quarter miles to the residence of Dr. Van Duyn. 70 
It enters the blood unchanged. It is thrown off by 
the skin, lungs, and kidneys. It affects powerfully the 
vaso-motor system of nerves. It causes liypermmia of 
the brain, and (theoretically) of the spinal cord. It 
stimulates glandular action. It is cathartic. It is 
diuretic. It is highly irritant. It is stimulant. It is 
an intoxicant. It is a narcotic, and it increases the 
temperature of the body. 
Detection of its administration seems to depend more 
on the direct effects of the drug than on any modifi- 
cation it may have power to produce in the symptoms 
of the resulting abortion. Its remarkable odor, even 
in doses of 5 m., will be evident in the urine, and when 
its use is pushed to 10 m. or more, it seems to impreg- 
nate the whole depuration of the body. Its terebin- 
thinate smell is in the clothes of the patient, and air of 
the room, and will be perceptible for twenty-four hours 
after a full dose. The presence of the odor of the drug 
about the patient during an alleged dysmenorrhoea, or 
admitted abortion, ought to excite inquiry. Severe 
headache, flushed cheeks, or nausea, and especially the 
pressure-like pain round the head at the temporal region 
would be an unusual complication, and, as such, ought 
to receive attention. If the use of the drug is pushed 
to its cathartic effect, the pain and flatulence, and the 
peculiar burning pain at the anus, taken in connection 
with the presence of the odor of the drug, and add to 
this frequent micturition, with or without strangury, 
and we would have almost positive proof of the adminis- 
tration of the drug. If the use of the drug is continued 
until toxical effects are produced, it would be evident 
that some extraordinary cause is at work, and there 
would be no difficulty in detecting the poison, as in 
ordinary cases suicide forms no part of the patient’s 
plan. In nearly all cases the presence of the savine 71 
odor, in connection with the usual symptoms produced 
by the drug, would be strong confirmation of its dosing, 
and, as savine is scarcely used in ordinary practice, we 
ought to regard with suspicion any attempt the patient 
may make to explain the use of the drug, by a physi- 
cian’s prescription, or as treatment for an alleged com- 
plaint. 
Tests. — When taken in the form of decoction or in- 
fusion it is beyond the reach of chemical tests.* The 
most common form in which it is used in England, is 
that of powder. In that case, vomited matter of the 
color of green-pea soup, or of altered bile, if treated 
with water the green coloring matter will subside, in a 
dense insoluble stratum, when, if the color was due to 
altered bile, the whole of the liquid would remain col- 
ored.f If the green matter is washed in water and 
dried, and placed under a microscope, evidence may be 
obtained by the rectilinear fibres and the turpentine 
cells that the substance belongs to the coniferse. 
The oil is that part of the plant which is in the most 
common use in this country. It responds to the follow- 
ing tests: Stain on paper entirely dissipated by heat. 
It gives to water an acid reaction, J and is insoluble. 
It forms a milky-white solution with rectified spirits. 
A clear solution is formed by the oil with ether. 
Nitric acid in the cold gives to the oil slowly a dark 
red-brown color. 
Tansy ( Tanacetum vulgare). — This drug in the es- 
timation of women is a potent abortifacient. I am at 
this writing attending a woman through an abortion 
who claims it was brought about by taking oil of tansy 
in five-drop doses three times a day. Women will men- 
tion case after case among their acquaintances whom 
* Taylor on Poisons, p. 502. 
X Loo. cit. 
t Loc.'cit. 72 
tansy “ relieved.” I have no hesitation in ascribing to 
tansy abortifacient powers. The popular belief must 
have some foundation in fact. 
In tansy, we are dealing with a drug of remarkable 
power. Like savine, it may act by causing great en- 
gorgement of the venous circulation of the viscera gen- 
erally, and particularly of the pelvis. It also resembles 
savine in its action on the urinary organs. Here all re- 
semblance in their action ends. In the cure of amenr 
orrhoea, tansy is justly regarded as highly as savine. 
They use different means to attain the same end. Sa- 
vine seems to induce venous congestion, in a great 
measure, by its irritant properties, while tansy has no 
irritant action upon the primse vise, but seems to induce 
congestion by its peculiar action over the vaso-motor 
nerves. The fact that tansy fails to induce abor- 
tion, even when taken in sufficient amount to cause 
death, is no evidence against its power as an abortifa- 
cient, as its fatal effects follow in such a short time that 
the womb is unable to respond in any manner to the 
stimulant. 
Tansy has three stages of action, first as a stimulant 
tonic, as an excitant to the venous circulation, and as a 
violent poison to the brain and spinal cord, selecting 
the cord as the field of its primary action. It is the 
second stage of its action which enables it to rank as 
an abortifacient. Without being able in any manner to 
cause expulsive efforts on the part of the womb — thus 
being called indirect — it may render the organ unten- 
able by inducing uterine apoplexy; or a condition ap- 
proaching it to such an extent that the womb is roused 
to action. Women who have used the oil of tansy — 
and it is not difficult to find them — inform me that 
they find a heat and fulness through the hips, which 
increase as they persist in the use of the drug, until 73 
final]}7 they have a “ show.” I know of one elderly 
married woman who says that it is the most efficient of 
the drugs in the early months, and would bring on 
flowing when all other drugs failed. However true this 
may be, tansy is a tradition among American women 
for its certainty as an abortifacient. The oil is largely 
adulterated. I had trouble in finding a pure specimen 
for my experiments. Of one specimen of the oil, 95 m. 
were injected hypodermically at intervals during three 
hours, and 2| drachms into the rectum of the same dog, 
without causing any marked symptoms. 
The most marked symptoms of tansy toxaemia are a 
rapid disturbance of the nervous system, a profuse sali- 
vation, immobile and dilated pupils, and severe stran- 
gury. These symptoms in animals appear rapidly and 
together, as shown in the following: — 
Experiment I. — Dog four months old. At 9.30 A. 
M., oil tansy, 3ii, was injected into the stomach; 
10.15 A. M., vomited frothy mucus, appeared dull, 
passing a few drops of urine as often as every minute, 
lavish secretion of saliva; 10.25 A. M., pupils dilated 
and immobile, twitching of muscles; 10.30 A. M., 
powerful clonic convulsions, ribs fixed, respiration 
diaphragmatic; 10.35 A. M., passed out of convul- 
sions, stood upon his legs, passed into a semi-cata- 
leptic condition, in which the body remained in an 
unvarying attitude, consciousness not being lost; 11.15 
A. M., began to move about, and rapidly recovered 
from the effects of the poison; 12.45 P. M., repeated 
3 ii oil tansy. Caused no marked symptoms except 
salivation. Dog remained standing nearly all the after- 
noon in a sort of cataleptic condition. Next morning 
quite lively, and ate a hearty breakfast. 
Experiment II— Same dog, four days after above 
observation, apparently none the worse for experiment 74 
Ho. 1; 9.40 A. M., injected § ss of oil t. into stomach; 
11 A. M., convulsions, same as described in Exp. I., 
as also tjie same symptoms presented themselves; 12 
M., it being evident the dog was recovering from the 
poison, § ss of oil t. was thrown into the stomach; 1 
P. M., animal entered into a prolonged convulsion of 
clonic character, in which death took place, seemingly 
from paralysis of the muscles of respiration, the dog 
dying from asphyxia. At 4 P. M., Dr. Van Duyn 
made a most careful dissection, two hours and a half 
after death, with the following results: Brain — Large 
collection of serum under dura mater, veins of the pia 
mater highly congested, small amount of serum in the 
lateral ventricles. Cerebellum, its meninges highly en- 
gorged, and on section its substance showing numer- 
ous centres of congestion. Pons Varolii greatly con- 
gested. Cord, large effusion of serum under the dura 
mater, vessels of the pia mater congested. Lungs con- 
gested to a state of hepatization. Coronary veins of 
heart beautifully mapped out by their engorgement. 
Heart, left side empty and contracted, right side full of 
fluid blood. Stomach and intestines gave a strong tansy 
odor, but no evidence of inflammation. Kidneys con- 
gested. Bladder contracted to the dimension of a fluid 
drachm. Mucous membrane corrugated and congested. 
Experiment III.— After taking a preliminary trac- 
ing with the sphygmograph, I took 10 m. of oil of 
tansy in simple syrup. There was an immediate sense 
of heat in the stomach, and in about fifteen minutes a 
sense of fulness of the head and face, and the feeling 
of warmth diffused over the whole abdomen. At inter- 
vals of half an hour, tracings of the right radial pulse 
were taken. In about half an hour there was a slight 
giddiness, and a marked diuretic action, the urine 
being strongly impregnated with the tansy odor. The 75 
diuretic action continued during the night, being 
obliged to rise and urinate, — a very unusual occur- 
rence. The experiment was limited to one dose, and, 
it will be noticed, double that authorized for legitimate 
use, in order to observe its influence upon the pulse 
when taken within the limit of safety. 
Experiment IV. — Fifteen m. doses of the oil were* 
taken at intervals of four hours. Two doses were taken 
in all. After the first dose great heat of stomach and 
bowels, the face flushed, and after about fifteen minutes 
a very unpleasant sense of fulness within the head. 
Half an hour after, urine passed in increased quantity, 
Fig. 1. —Standard tracing in health fifteen minutes before experiment. 
Fig. 2. — Twenty-five minutes after taking ten m. of ol. tansy. 
Fig. 3.—Fifty-five minutes after. 
Fig. 4. — One hour and fifteen minutes after. 
Fig. 5. — Two hours after. 
Fig. 6.—Thirteen hours and fifteen minutes after. 
high-colored, and of strong odor of the drug. Pulse 98. 
Temperature 99°.5 P. Flatulent eructations from the 
stomach, tasting intensely of tansy. Urinated three 76 
times in the four hours. Three hours after, any un- 
pleasant effects, except the eructations and uresis, had 
passed away. Second dose. The above symptoms were 
all renewed. It is doubtful if all the first dose had been 
absorbed, as in twenty minutes there was ringing in the 
ears, dizziness. One hour after, there was also a prick- 
ing sensation in the extremities, with flashes of heat; 
a strange fulness and sense of pressure within the head 
amounting to pain. In one hour and twenty minutes 
after, the urine produced a slight scalding, and the desire 
to urinate was constantly present, but not strangury. 
Two hours after, there was thirst, and a strong desire to 
draw a full breath, which did not give relief to the 
oppression in the chest when drawn. The dizziness 
still continues, but the mind clear, so I think I am 
observing accurately my condition. Two hours and 
three quarters after, there were the same symptoms 
present, the dizziness however being less, as also the 
sense offulness of head and face. Pulse 115. Tern. 100°.5 
F. Three hours and a quarter after, I am somewhat 
drowsy. Repeated tausy eructations, and borborygmus. 
Three hours and a half after, went to bed drowsy but 
restless, the pricking sensation coming and going over 
the extremities and along the spine, weight at the 
stomach, breathing slightly oppressed, sense of uneasi- 
ness, but not pain, in the head, constant desire to urinate 
still present. About five hours after, I took a large 
dose of opium, which procured me sleep. The next 
morning there was an occasional eructation of tansy, the 
urine smelling strongly of the drug, high-colored and 
until noon often voided. Disinclination for breakfast, 
but ate a hearty dinner. A dose not much larger than 
the one recorded above has been known to cause con- 
vulsions. In my case I had been living for about ten 
days in a strong tansy atmosphere, and had gradually 77 
accustomed the system to the drug by former and smaller 
doses, which may account for the comparative mildness 
of the symptoms. 
Dr. Binkerd records a case in which convulsions and 
coma and a cataleptic condition followed fifteen or 
twenty drops as a dose.* There was also heat and burn- 
ing in the oesophagus; after three hours there was dizzi- 
ness and numbness, which gradually increased to nearly 
paralysis. Then convulsions followed by vomiting. 
The pulse was 90, and pupil dilated. Skin moist and 
warm, and pain in the head. The comatose condition 
persisted for an hour. Death always occurs in tansy 
poisoning, with violent convulsions, wdiich come on 
usually in about three hours, and seem to terminate 
fatally from paralysis of the muscles of respiration, and 
from what I have observed of the condition of the left 
cavities of the heart, paralytic fixure of the respiratory 
muscles is the chief phenomenon in the fatal issue. 
From the sphygmographic characters of the pulse trace, 
the former opinion that tansy was a stimulant, like 
narcotics generally in their action, to the heart, is wrong. 
There is increase in the rapidity of the heart’s action, 
but not in systolic power. 
The operation of tansy on man may be epitomized as 
follows: It acts as a powerful excitant to the cerebro- 
spinal nerve centre, causing convulsions first, then co- 
ma. It is powerfully diuretic. It stimulates glandular 
action. It increases the heart’s action, but lessens car- 
diac systolic power. It suspends voluntary muscular 
force in poisonous doses, and, as a final result, all mus- 
cular power, and thus causes death by asphyxia. 
Detection of its criminal administration. — It may be 
already seen that a dose of tansy within the limit of 
safety produces few marked evidences of its use. Small 
* Med. and Surg. Reporter, Vol. xxiii., p. 538. 78 
doses will produce a diuretic effect, the urine smelling 
strongly of the drug. The odor is the most prominent 
detective sign; the fact that a bottle of the oil is in the 
room, which has been repeatedly corked and uncorked, 
will be at once detected by an acute nose. The odor, 
after a large dose, may be detected in the breath. In 
an alleged case of dysmenorrhoea, the discovery that 
the woman has been taking tansy would be sufficient 
to excite our suspicions, for women have a wholesome 
fear of the drug, and it is therefore rarely used in a 
simple menolipsis. Dilated pupils associated with a 
tansy odor would be an almost positive evidence of its 
use in a large dose. After a poisonous dose the whole 
person of the patient is redolent with the drug. If the 
patient vomits, the matter also smells of the drug, but 
vomiting does not usually occur unless associated with 
convulsions. Pricking of the limbs will be present, 
which may occur in flashes with a sensation of heat, or 
be localized, and I believe the pricking sensation may 
result from a dose which is far short of dangerous 
effects. Numbness may also be present, but is a grave 
symptom. 
Tests. — Peschier isolated from the leaves a pecu- 
liar acid, which he calls tanacetic, and which precip- 
itates lime, baryta, and the oxides of lead and copper. 
In an infusion of the plant, if the acid were present, it 
may respond in that manner to the above tests. The 
oil may be extracted by distillation. Dr. Raymond, by 
distillation of the vomited matter, procured over six 
ounces of ”tansy water.”* Ether readily dissolves the 
oil, which may then be separated for testing by distil- 
lation. The oil responds to the following tests: — 
(a.) The tansy odor, (b.) It is lighter than water, 
and deposits camphor on standing.f (c.) The oil set- 
* Amer. Jour. Med. Sci. N. S. n., p. 514. f Wood. 79 
ties to the bottom of the test-tube when agitated with 
a solution of the bichloride of mercury. (d.) It is 
soluble in alchohol and ether, (e.) It forms a cloudy 
mixture with chloroform. (/.) It turns dull red on add- 
ing nitric acid. It turns a beautiful aniline red 
with sulphuric acid. 
Rue (.Ruta graveolens.) — In the absence of positive 
evidence of the power of rue to effect directly the 
muscular structure of the womb, it is classed among the 
reflex abortifacients. It is a potent drug, and although 
its use in poisonous doses is not followed by fatal effects, 
still it ranks with tansy or savine as an abortifacient. 
It is quite popular among American women. The drug 
holds its place as a domestic expedient in many house- 
holds. Dr. Helie is of opinion that rue has a direct and 
elective action on the uterus, and that it may be regarded 
as a provocative of abortion independently of its irritant 
and narcotic effects. To support his views of the action 
of the drug, Dr. Helie gives three cases,* and as they 
are important, and instruct us as to the symptoms of its 
administration, I shall give them here. 
Case I.—A young female, dreading her second labor, 
procured three fresh roots of rue, cut them in pieces, 
and then boiled them in a pound and a half of water 
down to three small cupfuls, which she drank on going 
to bed. Dreadful pain in the stomach came on, with 
vomitings, and with such oppression that she thought 
she was dying. This state continued all night; the next 
day the symptoms were much abated. She then ex- 
perienced colicky pains, slight at first, but returning 
with greater severity at intervals. On the evening of 
the second day they became much more violent. She 
aborted forty-eight hours after taking the decoction of rue. 
* Med. Chirurg. Review, xxix., 604. 80 
Case II. — A young woman, residing in a farm-house, 
was suddenly seized with most severe vomiting, violent 
twisting pains in the abdomen and limbs, restlessness, 
and a tendency to delirium. She had all the appearance 
of being intoxicated. She seemed to be in the seventh 
month of pregnancy, although she positively denied it. 
In the course of the following day she was delivered of 
two infants. Alarming symptoms of poisoning came on 
afterwards, but these subsided by degrees, and she 
ultimately regained her health. She afterwards admitted 
that she had made use of a strong decoction of rue 
leaves. 
Case III. — A girl, in the fourth month of pregnancy, 
took for several days a strong dose of the expressed 
juice from fresh rue leaves. Vomiting, severe colic, 
great prostration, and a tendency to syncope, somno- 
lence, delirium, and coldness of the whole surface came 
on. There was also, as in the preceding case, an in- 
flammatory swelling of the tongue, accompanied with a 
profuse salivation. The expulsion of the foetus did not 
happen until the sixth day after taking the rue. The 
acrid-narcotic effects did not cease altogether for an- 
other week. Dr. Helie’s paper appeared in the Annals 
d Hygiene, Pub. et tie Med. Leg., xx., 180. Its action in 
diminishing the force and frequency of the heart’s move- 
ments appears to be as marked as that of digitalis. In 
some cases under its influence, the pulse has fallen to 
thirty beats in a minute. Its peculiar inflammatory 
influence on the tongue deserves to be remembered. 
{Log. cit.) 
Experiment. — Ten minim doses of oil of rue were 
taken at the following intervals: at 9.05, 9.30, and 9.55 
P. M. After the first dose there was warmth at the 
stomach, a sense of uneasiness in the head. After the 
second dose, there was uneasiness in the stomach, pain 81 
in the hack, an oppressive feeling in the head, slight 
confusion of ideas, and occasionally a feeling of faintness. 
The third dose intensified the above symptoms, the 
pain over the kidneys was more marked, with an urgent 
desire to urinate. Flushes of heat passed over the body, 
and there was an indescribable sense of nervousness, 
which created a fear that an over-dose had been taken. 
The urine, when passed, gave a strong odor of rue. 
The confusion of mind was' controllable by an effort of 
will, as also was the general feeling of nervousness. 
The pulse was increased in frequency. The pupils were 
normal. The gait was unsteady. The tormina at the 
stomach was in a great measure appeased by drinking 
milk. For several hours after the desire to micturate 
was constantly present. During the night the effect of 
the rue was that of any narcotic drug upon the subject 
of the experiment, — but little sleep, and great rest- 
lessness. In the morning no ill effects were observed. 
During this experiment sphygmographic observations 
were made. 
Abortion follows the use of rue in much smaller doses 
than those mentioned by Dr. Helie. A woman informed 
me that she used an infusion of the dried leaves, in the 
form put up by the Shakers, about two ounces to the 
quart of water, of which she took a teacupful night and 
morning. It always produced an abortion. She had 
employed it for this purpose several times. The symp- 
Fig. 1. — Standard trace in health. 
Fig. 2. — Twenty minutes after taking 10 m. oil of rue. 82 
Pig. 3. — Twenty minutes after 2d dose of 10 m. oil of rue, and forty-five minutes after 1st dose. 
Pig. 4.—One hour and ten minutes after 1st, forty-five minutes after 2d, and twenty 
after 3d dose of 10 m. oil rue. 
Pig. 5. — One hour and forty-five minutes after 1st, one hour and twenty minutes after 2d, and 
one hour after 3d dose oil rue. 
toms, as she described them were those resembling the 
criminal use of savine, or tansy ; pain in the bach, 
bearing down, frequent micturition, continuing for 
several days, and oftentimes attended with headache, 
when there would be a " show,” with colicy pains and 
abortion, which would follow in a week or ten days 
from the beginning of the dosing. This is the common 
form in which it is used, rue being a very popular herb. 
One reason for the very common use of the herb, is, 
probably, the great adulteration of the oil. Oils pro- 
cured from the best houses in New/York are so adulter- 
ated that no danger attends their use in doses live to 
ten times greater than that mentioned by the authorities. 
Rue exerts a remarkable power over the kidneys. These 
organs seem to be the chief seat of its elimination. A 
strong odor of the drug may be detected in the urine 
for twenty four hours after its use in full doses. The 
breath, for the first two or three hours after its use, is 
also full of the odor. It will be observed in my experi- 
ment that the power of the oil was not exhibited in 
reducing the frequency of the pulse, although its force 
was diminished. In an experiment I made with an in- 
fusion of the dried leaves,—a Shaker preparation,—of 
the strength of an ounce to a pint of water, this power 
to lessen the frequency, as well as the force of the 83 
heart’s action, was evident, reducing the pulse from 80 
to 69 in about three hours. 
In an abortion, the result of the exhibition of rue, in 
case the drug was used in excessive doses, there would 
be the symptoms detailed in the cases of Dr. Helie. In 
more moderate doses there would be syncope, or a 
tendency to it, drowsing, a reduced pulse, a peculiar 
feeling of nervous restlessness, back ache and bearing 
down, and a diuretic effect. There would be a history 
of a persistence of these symptoms for a week, or even 
more, before the pains, characteristic of uterine contrac- 
tions, came on. If the oil were used, its peculiar odor 
would pervade an apartment for hours afterward. Rue 
does not possess the strong individuality which is so 
prominent a feature in most of the other fceticidal drugs. 
Its use, therefore, in moderate doses would be unattend- 
ed by the marked effects characteristic of small doses of 
the potent drugs already considered in this monograph. 
The use of the rue in any manner approaching an over- 
dose would hardly escape our notice, as the symptoms 
here detailed would form prominent features iij the case. 
From my own observations, and from those of others, 
we may deduce the following as the probable effects of 
rue on the system of man. It is a narcotic, and an 
irritant to the intestinal canal. It depresses the action 
of the heart. It powerfully stimulates glandular action, 
and acts potently on the kidneys. It has a marked 
action on the spinal system of nerves, causing spasmodic 
muscular movements, and possibly an elective power 
over the muscular structure of the womb. (Helie.) 
Tests.— Of the infusion of the plant, I know of no chemi- 
cal test. The oil responds to the following reagents: — 
(a.) The oil forms a clear solution with chloroform, 
alcohol, and ether. 
(1).) The solution of the oil in chloroform, treated by 84 
nitric acid, is decomposed, large oil globules floating 
upon the surface. 
(c.) The oil and nitric acid gtt. form a dark red 
solution supernatent to the discolored acid. 
(<Z.) A solution of the oil in alcohol forms a milky 
solution with nitric acid, which clears up by boiling, and 
after a few minutes forms a cloudy pinkish solution. 
(e.) Its peculiar odor. 
(c.) Those drugs which are combined pharmaceuti- 
cally and unite the action of (a) and (b). 
Detection of the criminal use of proprietary nostrums.— 
I have already detailed the effects of the principal 
abortifacients, and as they comprise those which usually 
enter into the composition of the more potent of those 
preparations which are sold under the name of "female,” 
or "periodical pills,” or "drops,” this part of the subject 
may be briefly considered. 
Those sold in pill form are, so far as my knowledge 
of them goes, composed largely of aloes, iron, and 
powdered savine, or aloes in combination with some 
more active cathartic. All of the periodical pills when 
taken in large doses produce a cathartic -effect. So far 
as my observation of this cathartic action of " female 
pills ” extends, it is owing to the presence of aloes. The 
dose of these pills varies from three to ten, according to 
the printed directions with each package. It, therefore, 
follows that when aloes forms a principal ingredient, and 
is taken in large and repeated doses, the effects of 
aloetic purgation, as formerly detailed, will be a promi- 
nent feature. Hooper’s female pills form a good type 
of the ordinary periodical pill. To avoid repetition, the 
remarks formerly applied to the detection of the ad- 
ministration of aloes will also apply to these pills. If 
savine, either in substance or oil, forms an ingredient, 
it will be evident in the same manner as if taken sine:lv. 
* O J 85 
It is doubtful if ergot is given in this form whether it 
will furnish any evidence of its use. The same causes 
which led to the great difference between the effects of 
the legitimate and the criminal use of these drugs also 
apply with equal force here. Women, in using these 
nostrums, push their use to the same injudicious extreme. 
They give their confidence with the same reluctance, 
and exhibit to the physician the same suspicious reti- 
cence, and a surprising degree of modesty about func- 
tions which possibly may have formed the subject of 
conversation with her medical adviser a score of times 
before. 
It is important, if the physician is to be an efficient 
detective, that he becomes familiar with the appearance 
and the method of putting up for the trade these 
"periodical pills.” Their appearance is characteristic, 
being the result of an apparent attempt to conceal the 
nature of the contents of the bottle or box when in use. 
Thus they are put up in small and partially opaque glass 
bottles, in square tin boxes, or in small cylindrical tin 
boxes, covered by a wrapper, but having no label pasted 
directly upon the box. It is important that the country 
practitioner should become familiar with the effects and 
appearances of these nostrums, as they are used largely 
in the country. Several extensive wholesale dealers 
have informed me to that effect. 
We wrill now consider a far more dangerous class,— 
those preparations known as ” periodical drops.” 
w Periodical drops ” usually number among their active 
ingredients some of those potent oils already considered, 
which are not only more certain as abortifacients, but 
also more dangerous to the life and health of the woman. 
One specimen, which a lady told me she had taken two 
teaspoonfuls of, but was obliged to desist because of its 
irritating effects upon the stomach, was composed of a 86 
dark fluid,—apparently some fluid extract,—upon the 
surface of which floated about three drachms of oil 
globules, of a light orange color, with the odor and taste 
of savine. The dose was from three to four teaspoonfuls 
a day. I deem this mixture highly dangerous. It is 
one of the most popular of these mixtures and of which 
there are large sales. 
These fluid mixtures possess a great advantage over 
the pill form in the facility Avith which the potent abor- 
tifacient oils are mingled in the combination. Those 
drugs most likely to form part of such mixtures are the 
infusion or oil of savine, tansy, in infusion, or oil, ergot, 
and extract of cotton root. From the fact that they are 
offered to the trade in small packages, it is probable that 
the oils are used, as indeed could be plainly seen in the 
mixtures I have examined. The detection of the crimi- 
nal use of the periodical drops must depend on the 
nature of the mixture. In the sample referred to, it is 
evident a sufficient dose of the oil of savine Avould be 
taken to cause its physiological effects, and even a 
poisonous dose may be taken if the bottle be not shaken 
so as to thoroughly incorporate the oil. The symptoms 
would evidently be the same as when the oil Avas taken 
alone. The nature of the mixture Avould be betrayed by 
the powerful odor of either savine or tansy. !No phar- 
maceutic skill could cover up the remarkable taste or 
smell of these drugs. If extract of ergot or cotton root 
also exists in these mixtures, it is doubtful if the detec- 
tion of their use is possible with our existing knowledge. 
If ergot enters into the combination of these mixtures 
in sufficient amount, which is doubtful, the rules before 
given for its detection Avould also apply here. 
In the matter of the detection of the criminal use of 
those mixtures prepared by the druggist himself, and 
sold over his counter, much would depend upon the dose 87 
given. It is usual in these mixtures to give prominence 
to some one ingredient. Tansy, savine, or ergot would 
thus occupy a leading place,—the other drugs which may 
be present being thrown in with a vagua idea that they 
would in some way aid to bring about the desired result. 
Iron, in some form, is added very often, from an imper- 
fect knowledge of the action of iron in irregularity of 
the menstrual function. Powerful cathartics, either in 
infusion or solid form, are also placed in the mixture, 
with a better defined idea. When the druggist gives 
the applicant either of the oils of savine or tansy, singly, 
it is generally in simple syrup or in mucilage. In this 
case the peculiar odor would at once indicate the char- 
acter of the compound. The same would hold true of 
either the above-named oils in combination. These oils 
are sometimes prescribed in such minute doses that no 
effect would be evident from their use. Those men who 
thus prescribe have the very best of intentions to aid their 
customer, but are too timid in the use of the instruments. 
The remarks previously made in regard to the detection 
of the criminal use of the abortifacients named, apply 
here. 
In regard to the detection of the use of mixtures 
containing active doses of all the foeticidal drugs, as is 
sometimes given, — and I know of one druggist who 
habitually gives such a combination when the parties are 
" all right,” — we would generally, I think, find a woman 
sick from the use of a mixture of which she would be 
unable to give a reliable account. Anomalous symptoms, 
such as great irritation of the stomach, persistent cathar- 
sis, headache, a sharp quick pulse of irritation, if ergot 
were not present in a full dose, and a frequent desire to 
urinate, if not strangury. If ergot was, however, 
present in a full dose, and used as freely as such mixtures 
usually are, we would have a pulse down as low as 50 88 
or 60 per minute, of a dull, lingering character under the 
touch, and at the same time the anomaly of more or less 
acute irritation of stomach and intestines. All these 
symptoms might exist intercurrent with an admitted 
pending abortion, or a dysmenorrhcea assumed to exist 
to cloak the abortion. A mixture of such a nature 
would be readily recognized if found in the room of the 
patient, for it would resemble no mixture that a physician 
in his senses could prescribe, and the combined odor of 
tansy and savine would at once betray it. Generally, 
however, druggists give some one abortifacient a lead- 
ing part in the mixture. If in the pill form, aloes is 
chiefly relied on. If in the fluid form, some one of 
the potent abortifacient oils is the principal ingredient. 
Whichever is used I have already detailed their usual 
symptoms. It is therefore needless to repeat them here. 
Although I have made a separate class (c) of the 
mixed fceticidal drugs, it will be observed that usually 
the detection of their administration rests upon the 
operation of one or more prominent ingredients; and 
thus less able to get at the nature of the compound by 
a chemical examination, the detection of their adminis- 
tration from the symptoms resulting is not less difficult 
than when taken singly. PHYSIOLOGICAL ACTION 
OF 
NITROUS OXIDE, 
AS snown BT 
Experiments on Man and Lower Animals. 
ROBERT AMOR Y, M. 33. 
Lecturer on the Physiological action of Drugs In the Medical Department of Harvard University. 
Illustrated by Pulse Tracing with the Sphygmograph, 
PAMPHLET, 8vo. PRICE, 50©. 
JAMES CAMPBELL, Publisher, 18 Tremont St., Boston, Mass. 
A. CONTRIBUTION 
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With experiments on Lower Animals, 
Made at La Gr* ige St. Laboratory, 1869, by 
ROBERT AMORY, M. D., S. G. WEBBER, M. D. 
One col. 16mo. Cloth, 76 cents. Pamphlet, 60 cents, 
gar Seat by mall, pottage free, on receipt of advertised price. 
James Campbell, Publisher, 18 Tremont St, Museum Build in#, Boston* Mum 
The Gynaecological Record: 
\ BOOK of blank forms, intended as an aid to the busy practitioner in recording 
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EXTRACT FROM THE PREFACE. 
“This hook is intended to aid the busy practitioner in making detailed and systematic records of cases 
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The tables for the analysis of cases are few in number and simple in their plan.” 
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Notices of the Medical Press. 
“ It is seldom that we have seen a book, whether on a medical subject or any other, so thoroughly unex- 
ceptionable in its mechanical execution, as this. And we take pleasure in making unusually full notes of 
it, with copious extracts from its pages. 
“ The index is full and well arranged, a model in these respects for medical writers generally. The 
work as a whole is eminently practical and valuable, meeting a demand which is certain to place it in the 
library of every homceophatic physician.”—New England Medical Gazette. 
“The work is strictly practical, and interspersed with interesting cases which illustrate the author’s 
method of treatment very clearly and fully. We attach special value to this feature of Dr. Angell’s book, 
for lie writes not merely on the evidence adduced by others, but brings the experience of his own matured 
practice to bear on the different points of treatment which is illustrated at large by the record of cases. 
We have read the book with great interest, and derived much practical instruction, which cannot fail to 
tell favorably on our treatment of diseases of the visual organs that may subsequently come before us.”— 
Momasovhatic World, London, June 1, 1SN\. 
Contributions to Dermatology 
Eczema. 
Ecthyma. 
Impetigo. 
Rupia. 
Scabies. 
Lupus. 
OONBTJLTINa PHYSICIAN BOSTON OIT~V HOSIPIT-A-X.. 
SILAS DURKEE, M. D. 
8vo. Pamphlet. Price $1.50. 
PUBLISHED BY J A M E S CAMPBELL, 
Medical and Scientific Bookseller, 
18 Tremont Street, Boston. 
Physician’s Register, 
FOR OFFICE OR HOSPITAL PRACTICE. 
This is an imperial 8vo. book of blank forms, similar to the book used in the Dispensary, for re* 
fording the date, name, residence, age, and disease, with a large blank space for remarks. 
James Campbell, Publisher, Boston, Mass. 
Price $1.50. 25 cts. extra when sent by mail. TWO CASES 
OF 
CESOPHAGOTOMY 
FOR THE 
REMOVAL OF FOREIGN BODIES; 
WITH a 
HISTORY O IF1 THE OPEBATIOTT. 
Second edition, with an additional case. 
BY DAVBD W. CHEEVER, M.D. 
Adjunct Prtfecaor of Olinioal Surgery at Harvard University | Surgeon to the Boston City Hospital. 
1 vol., 8vo. Cloth. $1.25. 
Bent by mall, postage prepaid, on receipt of price. 
JAMES CAMPBELL, Publisher, 
18 Tremont St., Museum Building, Boston, Mass. 
METHOM AMI A: 
-A. Treatise on YA. 1 c o li o li c Poisoning. 
BY ALBERT DAY, M.D. 
Superintendent of the Neu> York State Inebriate Asylum. 
1 volume, 16mo. Cloth, bevelled boards. 60 cents. The same In paper covers, 40 cents. 
NOTICES OF THE PBESS. 
This little volume Is a treatise on those poisons which first stimulate, then narcotize. The author has had 
ample means to thoroughly investigate his subject, having had over two thousand cases under his care, a great 
many of which were suffering under one of the different forms of mania apotu. 
Dr. Storkr says: “ I take pleasure in acknowledging alike the excellence of the treatise he has written, 
its strictly philpsophical spirit, the practical influence it must have upon the community, and above all, the truly 
scientific manner in which ebriety and its effects, almost for the first time in the history of medicine, are now 
being treated at his hands.” 
It is a concise and useful statement respecting a matter of*painful interest, and will be read with profit bj 
all who wish to investigate the subject.—Sunday Times. 
“As a contribution to medical and reformatory literature, it Is both scientific and popular.”—Boston 
Recorder. • 
Sent by mail, postage prepaid, on receipt of advertised price. 
JAMES CAMPBELL, Publisher, 
18 Tremont St., Museum Building, Boston, TWhj»« 
IR.IEJh.ID'Z’ X1ST IFIEIBie-TX 
PHYSIOLOGICAL AND THERAPEUTICAL ACTION 
OF THH 
Bromide of Potassium and the Bromide of Ammonium 
ON MAN AND ANIMALS. 
IN TWO PARTS* 
EDWARD H. CLAUSE, M.D., 
Professor of Materia Medica in Harvard University 
BY 
ROBERT AM0R7, M.D., 
Lecturer on the Physiological Action of Drugs, in the 
Medical Department of Harvard University. 
AND 
Paht I. The Physiological and Therapeutical action and value of the Bromide of Po- 
tassium and its kindred Salts. By Prof. Edward H. Clarke. Part II. Experiments 
illustrating the Physiological and Therapeutical action of Bromide of Potassium and Ammo- 
nium on Men and Animals. By Robert Amort, M.D. 
ONE VOLCME. l«mo, CLOTH. $1.50. 
JAMES CAMPBELL, Publisher and Bookseller, 
BOSTON MASS, PHYSIOLOGY OF WOMAN 
AND HER DISEASES 
From Infancy to Old Age, 
Including all those of her critical periods, pregnancy and childbirth, their causes, symptoms, 
and appropriate treatment, with hygienic rules for their prevention, and for the 
P* reservation of” Fe m ale H ealth. 
Also, the management of Pregnant and Parturient women, by which 
their pains and perils may be greatly obviated, to 
which is added 
A Treatise on Womanhood and Hianhood, 
LOVE, MARRIAGE, AND HEREDITARY DESCENT, 
Being the most approved views of modern times, adapted to the instruction of females 
and professional reading. 
. IN THREE ROOKS—COMPLETE IN ONE VOLUME. 
BY C. MORRILL, M. D. 
Author of Sundry Medical Essays, Lectures on Popular Physiology, etc. 
SEVENTH EDITION. 
On® Volume, 13mo, Cloth., - - ......... $1.60. 
Sent by mail, postage free, on receipt of advertised price. 
A circular, with recommendations and a synopsis, mailed free on application. 
JAMES CAMPBELL, Publisher, 
78 TftJZMOJV'T STEUZJT, MUSZJUM &ZTIZ2)ZJV'G, 
BOSTON. MASS. 
The History and Philosophy of larriage; 
OR. 
Polygamy and Monogamy Compared, 
By a Christian Philanthropist. 
One Volume, 16mo. Pages, 356. $1.35. 
OPINIONS OF EMINENT LITERARY MEN. 
Of Notices repeived from competent judges to whom this work has been submitted, we 
Insert the following,— 
From the Hon. G. W. Curtis, M. A., Professor of Recent Literature in Cornell 
University, 
I have read the proof-sheets of “ The History and Philosophy of Marriage," in 
which the author treats a very difficult and delicate subject with knowledge, candor, and 
evident honesty of purpose. It is the contribution of an ai'gument, usually wholly uncon- 
sidered, to the discussion of a question which challenges the grave attention of civilization, 
and which Mr. Lecky treats in his recent “History of European Morals,” reaching, however, 
a conclusion directly opposed to that of this little work. This book has the curious dis- 
tinction of being a Christian plea for polygamy. I do not agree with its conclusions; but I 
cannot quarrel with its spirit. 
July 9, 1869. ‘ GEORGE WILLIAM CURTIS. 
From F. B. Sanborn, M. A., Associate Editor of the Springfield Republican, 
The author of “ The History and Philosofhy of Marriage ” some time since sub- 
mitted his manuscript to my examination, and I have read, with interest, the greater part 
of the work. It advances opinions with which I cannot agree, anil these are based upon 
premises that I should very much question; but, as the expression of a sincere conviction 
founded on extensive observation and reading, it seems to me entitled to attention, respect, 
and refutation, by those competent to meet the arguments presented with other arguments, 
and not with mere contradiction. 
Springfield, Aug. 13, 1869. F. B. SANBORN. 
JAMES CAMPBELL, Publisher, 18 Tromont St, Museum Building, Boston, Mass. 
$gr Sent by mail, post age prepaid, on receipt of the advertised prioe. • AU V XRTMfil*LK2fX&. 
NOW COMPLETE, WITH LETTERPRESS DESCRIPTIONS, 
OJT TKX 
DISEASES OF THE SKIN, 
rTj&JSZttl<r FZROIM: TJTB'331 
(TISIl IMS irmnTDBHOI OW 
HOWARD F. DAMON, M. D. 
FIRST SERIES. 
No. l.-Okreale Eescae. 
No Herpes (Zoster). 
No. O.—Impetigo. 
No. A.—Ec thyme. 
No. S.-Jtapla. 
No. O—Kupla (eneeler). 
SECOND SERIES. 
No. 1.—Alopecia Clrcumserlpt*. 
No. S.-Alepocl* 
No. S.—Herpes trie. 
No. A.— — elrelnetas et Iris. 
No. S.-lekthyoele aonyenlt*l, terms). 
No. (Umhsi. 
THTE.D S K SDPS« 
clrdiatu «l Tnnamti. 
Jf»« Ee«e»« Uarflaalui T«1 HtanM* (M»- 
elawtas. 
Na> »—Zoster Haarallt. 
No. Mypkllltlcws. 
No. (Syphiliticus Corpabana. 
No. 8.-JUckea Syphiliticus Anaalalat. 
FOURTH SERIES. 
No. 1.—AyphUeAermeTubereulesa TMssemtaata 
No. S.-fli|>klladoraia Tubereulosw Comfort* 
• t Oarymkoia, 
No. S.-Kapla ftyphlUtlea vsl Prominent. 
No. i.-l'ltni •ypkiUtleaa Memllueerf s. 
No. 3.-IJlc« Syphiliticus SorptglueeuB. 
No. «.-KaUa Syphilitic*. 
PEICB 
Per Number, consisting of Two Photographs, without Letterpress, , $1>00« 
Per Series, “ " Six “ " ...... 3.00. 
Photographs, complete, (24 Photographs with Letterpress description.) put ap la a seat Portfolio, . . I2.00i 
The Publisher takes great pleasure In announcing to the profession the completion of this valuable aerlea 
of Photographs of Skin Diseases. Numerous attempts have been made abroad to illustrate with accuracy, by 
the means or colored photographs and chromo-lithographs, cutaneous diseases; In some cases a very fair repre- 
sentation has been given, but in every case the photograph has been poor, and the details of the disease de- 
stroyed ; this will always be the case with colored photographs, unless made too expensive for the student. 
The object of Issuing the present series of photographs is to obviate this defect, and to present to the pro- 
fession illustrations of all the classes of cutaneous diseases, which, for accuracy and distinctness of outline, shall 
render great assistance to the student of Dermatology. , The selection has been made with great care by Dr. 
Damon, from several thousand cases which have come under his observation, daring the past five years, in his 
dispensary, hospital, and private practice, and that of other physicians. 
The following opinions are frem gentlemen of large experlenoe, and well known as practical Dermatologists: 
I have carefully examined Dr. Damon’s Photographs of Diseases of the 8kin, and, in my opinion, they are 
well suited to aid the student in the study of Dermatology. 
SILAS DUliKFE, M.D 
Bostox, August 88, 1M7. 
» Bkaoox Stxkkt, Bostox, August M, iW7. 
Dx. Damon: 
Dear Sir,—The Photographs yon have shown me of some Diseases of Um Bkia, an admirably taken. They 
would be useful aids to the student of Dermatology. Very truly, 
CHARLES QORDON, M. D. 
From th* New Tort Medical Record. January 15, 1868. 
“ The first two plates of this series which we have received are fine specimens of Art." 
From the Medical and Surgical Reporter, Philadelphia, February 8, 1868. 
“ They are very artistically executed, and display, with unmistakable clearness, the various dermic lesions." 
From the St. Louie Medical and Surgical Journal, May 10,1868. 
“ We do not hesitate to advise all who turn their attention to Skin Diseases to procure this cheap and 
efficient help." 
eSF For sale by all Medical Booksellers, or sent by mail, postage free, on receipt of price. 
JAMES CAMPBELL, Publisher, 
NOTICES FROM THE MEDICAL PRESS. 
18 Tremont Street, Boston, Matt, NEW BOOK ON THE EYE. 
HAND BOOK 
or THU 
DISEASES OF THE EYE. 
Their Pathology and Treatment. 
By A. SALOMONS, M.D. 
IMm» *f MU KnmmUmM MedUml BmHetpf furmter OeuUrt to timomit jSerwUt m$ 
FwfcnAtom, MmlUmd, Jt». 
Q» miiw, Mmm>. MtitoUto KagttU Clott. fl^a 
NOTICES. 
** A synopsis like this, which goes over so much ground in so small a space, Is advan- 
tageous to the student, in connection with clinical studies, and the perusal of more extended 
treatises. The definitions are carefully given, accuracy is observed, and lucidity is not sac- 
rificed to brevity. The operations recommended are carefhlly selected and described. That 
for Entropium we may particularly mention as in point.—Medical and Surgical Reporter" 
For anle by all medical booksellers, or sent bj mail, postage prepaid, on receipt of 
advertised price, 
JAMES CAMPBELL, Publisher, 
18 Tremont St, Unseam Building, Boston, Hass. 
SURGICAL CLINIC OF LA CHARITE. 
LESSONS 
Upon the Diagnosis and Treatment of Surgical Diseases, 
Delivered in the month of August, 1865, by Prof, Velpeau. 
OoltotoU aod JCdited by A.. RKGrN'.AJRJI), Intern* dee HoapltMU. 
REVISED BY THE PE0FES80B. 
TRANSLATED BY W. C. B. FIFIELD, M.D. 
1 votone, ltai». Clot* *1.00, 
2TOTIOZ3B Of TUB FREBS. 
"This modest little book contains a itatiitlcal rituirU. by the aathor, of hi* surgical experteaee ta the hco- 
yttal ward* under hi* care daring the year. He treat* hi* lubject under the tuooettiVe headier*: Generalise*, 
structures, Affection* of the Joint*, Inflammation and Abiceme*. Affection* of the Lymphatic System, Burn* 
tnd Contusion*, Affection* of the Genito-Urinary Organ*, Affection* of the Aural Region, Affection* of the 
Sye», Statistic* of Operation*. We hare a special liking for »uch work*, which fire a* the most authoritative 
opinion* of the elder* of the medical profession, who hare reached the time when the judgment 1* least biased 
»y the rivalries and personal influence* which are so apt to mislead yonnger minds. It 1* of vastly more value 
ban many more ambitious and bulky works.”—Boston Medical and Surgical Journal. 
“ He not unfreqnently surprises us by the simplicity of his expedients for the aid >f ‘ Nature in Disease,’ and 
arely, if ever, falls in making out his case. As a whole, the work is not only Instructive, but entertaining, and 
nay be regarded as one of our landmarks of minor surgery, upon our skill in which much of our suooess will ho 
ound to depend.”—Medical Record. 
“ It 1* rare that so small a hook oontalns so many suggestions of great practical worth, and throws so —■«* 
tght on oertain debated points, as Velpeau’s Lessons. Though nominally a review of one year's practice, it to 
a reality an epitome of the experienoe of a lifetime.’'—Detroit Review. 
“ All who valae the teachings of this great man will not lose the opportunity of obtaining them, aa we 
mated ha this brief and economical form.”- - Richmond Medical Journal. 
Bat l>7 mall, pocUgo propuli. on rooaipt of ndvortlsod prloa. 
JAMES CAMPBELL, Publisher, 
IS Tremoat St, Unseam Building, Boston, Baa, NOW BEADY, IN 8vo. CLOTH. FBICE, $2.50. 
THE 
Journal of the Gynecological Society 
OF BOSTON. 
Vol. I, 
OOITTEUTS. 
ORIGINAL COMMUNICATIONS. 
Necessity of Constitutional Treatment in Uterine Disease. By Henry M. Field, M.D. 
Frequency and Causation of Uterine Disease in America. By Horatio B. Storer, 
M.D., LL.B. 
Bromide of Iodine in Uterine Disease. By H. Gerould, M.D. 
Normal Position of the Pelvic Organs. By Prof. A. Breisky, of Berne, Switzerland. 
Scarification of Uterine Cavity. By J. G. Pinicham, M.D. 
History of American Gynaecology, Part I. By Horatio B. Storer, M.D., LL.B. 
Upon Pocketing the Pedicle in Ovariotomy; a Beply to Dr. Kimball, of Lowell. By 
Horatio B. Storer, M.D., LL.B. 
Phlegmasia Dolens; Its Pathology and Treatment. By J. G. Pinicham, M.D. 
Displacement of the Uterus Anteriorly. By Geo. II. Bixby, M.D. 
Betroversion with Hernia of Bladder during Gestation. By H. O. Hitchcock, M.D. 
Obliteration of Ovarian Cyst by Permanent Betention of a Canula. By John L. 
Sullivan, M.D. • 
Extirpation of the Puerperal Uterus by Abdominal Section. By Geo. II. Bixby, M.D. 
On the Delations of Fibrous Uterine Tumors to the Puerperal State. By Dr. IIorwitz, 
of St. Petersburg, Bussia. 
An Aid to Parturition and to the Treatment of Uterine Displacement. By Protiieroe 
Smith, M.D., M.B.C.P. 
The Delations of Physicians to Invalid Women. By Horatio B. Storer, M.D., LL.B. 
Unsuspected Bupture of the Uterus from Fatty Degeneration. By H. P. Stearns, M.D. 
An Outline History of American Gynmcology, Part II. By Horatio B. Storer, 
M.D., LL.B. 
Golden Buies for the Treatment of Ovarian Disease. By Horatio B. Storer, M.D., LL.B. 
The Pathological Sympathies of the Uterus. By Y. A. Taliaferro, M.D. 
Blood-Poisoning after Pelvic and other Surgical Operations, etc. By Carl Both, M.D. 
The Volume also contains the Transactions of the Society at 
its Begular Meetings, Editorial Notes, Literary Criticisms, Boohs 
Deceived, Ac., Ac. 
The Publisher would call the attention of the profession to the importance of the 
published volulnes of this Journal, containing as they do an extended report of discus- 
sions upon the diseases of women, by gentlemen skilled in their treatment; and, as is 
very well known, there is more to be learned from the perusal of such discussions, 
affording as they do diverse experiences concerning a given topic, than from a formal 
treatise by the most learned physician in the profession. It is not a mere re-cast of 
articles taken from the current Medical Journals, but is entirely composed of original 
material. Its editorials are always fresh, pointed, terse, effective, and on subjects of 
vital importance to the profession. 
JAMES CAMPBELL, Boston, Mass. NOW IlEALY, IN 8vo. CLOTH. PRICE, $2.50. 
Til IE 
Journal of the Gynaecological Society 
OF BOSTON. 
Vol. III. 
OONTE1TTS. 
ORIGINAL COMMUNICATIONS. 
Deaths from Sulphuric Ether. Its Relative Mortality probably higher than that of 
Chloroform. By Henry Austin Martin, M.D. 
Vaginismus mistaken for Spinal Disease. By Alexander R. Becker, M.D. 
Introduction of Horse Shoe Pessary into the Bladder. By Tom. O. Edwards, M.D. 
Aberrations of Gestation. By B. H. Catlin, M.D. 
Gastrotomy for the sake of the Mother, and not the Child. By J. II. Butler, M.D. 
On a New Clamp and some other Peculiarities in Ovariotomy. By Prof. T. 
Lazarewitcii, Ivharkoff, Russia. 
The Relation of the Female Sexual Organs to Mental Disease, Part II. By Prof. 
Louis Mayer, of Berlin. Translated by Geo. H. Bixby, M.D., with Notes by 
II. R. Storer, M.D., LL.B. 
Abdomino-Vaginal Impalement. By W. M. James, M.D. 
Absence of the Uterus. By Alfred C. Garratt, M.D. 
Local Treatment of Hemorrhage from Abortion by Persulphate of Iron. By Prof. 
E. M. Robertson, Charleston, S. C. 
The Object and Method of Recording Cases in Gynaecological Practice. Bv Joseph 
G. Pinkham, M.D. 
Complete Atresia Vaginae, etc., with Successful Operation for its Restoration. By 
J. H. Beech, M.D. 
The very Frequent and Inexcusable Destruction of Foetal Life in its Earlier Stages by 
Medical Men in Honorable Standing. By Joseph G. Pinkham, M.D. 
The Volume also contains the Transactions of the Society at 
its Regular Meetings, Editorial Notes, Literary Criticisms, Looks 
Received, Sc., Sc. 
The Publisher would call the attention of the profession to the importance of the 
published volumes of this Journal, containing as they do an extended report of discus- 
sions upon the diseases of women, by gentlemen skilled in their treatment; and, as is 
very well known, there is'more to be learned from the perusal of such discussions, 
affording as they do diverse experiences concerning a given topic, than from a formal 
treatise by the most learned physician in the profession. It is not a mere Te-cast of 
articles tgken from the current Medical Journals, but is entirely composed of original 
material. Its editorials are always fresh, pointed, terse, effective, and on subjects of 
vital importance to the profession. 
JAMES CAMPBELL, Boston, Mass. A SPECIAL MEDICAL JOURNAL 
THE 
JOURNAL OF THE 
GYNAECOLOGICAL SOCIETY 
OF BOSTON, 
.4 Monthly Journal, devoted to the Advancement of the 
Knowledge of the 
DISEASES OF WOMEN, 
Edited by WINSLOW LEWIS, M. D.; HORATIO R. 
STORER, M.D., LL.B.; GEO. H. BIXBY, M.D. 
Terms, $5 a-year, in advance. Single numbers, 50 cents. 
Half-yearly Volume, $2 50. 
The Journal will be under the editorial management of the officers of the Society, and no 
pains will be spared to render it creditable to the source from whence it emanates, and to the 
profession to which it looks for support. While devoted to the awakening of a greater interest 
in the knowledge of the Diseases of Women, the Journal will yet not wholly ignore matters of 
general medical and surgical bearing, inasmuch as it is upon general principles that all success- 
ful specialties and especialties must rest. It is impossible, however, now that general 
practitioners are so universally beginning to appreciate the importance, comfort, and pecuniary 
advantage ot a thorough knowledge of the diseases of women, for these to occupy any longer, 
in general or special journals, a subordinate place. 
IN COMMENCING THE ISSUE OF A SECOND YEAR OF THE GYNAECOLOGICAL 
JOURNAL, the Publisher would call attention to its peculiar recommendations to practitioners 
of Medicine and Surgery. 
1st. It is the only journal ever yet published exclusively devoted to the Diseases of Women 
2d. It presents, every month, an extended report of discussions upon these diseases, by 
gentlemen skilled in their treatment; and, as is well known, there is more to be learned from 
the perusal of such discussions, affording as they do diverse experiences concerning a given 
topic, than from a formal treatise by the most learned physicians in the profession. 
3d. It is not a mere re-cast of articles taken from the current medical journals, which are 
already supposed to be upon the table of ejiery active physician. 
4th. Its editorials are always fresh, pointed, terse, and effective; of that character, indeed, 
which made the London Lancet for so many years, while under the charge of the elder Wakley, 
the leading medical journal of the world. 
5th The Journal of a Scientific Society is the more likely to view the medical events of the 
day from a high and dignified stand-point—without, however, forgetting that to effectually 
clear anew path, and to remove obstacles in the way of progress, blows are frequently neces- 
sary, and that they must be heavy, vigorous, and conclusive. 
6th. The unexpectedly large circulation in every part of the country that it has already 
attained may be considered an indorsement of its excellence. 
Each Number will contain the transactions of the Society at its regular meetings 
(two each month), Original Articles, Editorial Notes, Book Reviews, &c., &c. 
Each number will consist of not less than 
SIXTY-FOUR PAGES, OCTAVO, 
PRINTED I NT LAItGE TATI?PC, OTST FINE (PAJPItfiR, 
and it will be the aim of the publisher to make it fully equal in appearance to anything of the 
kind in the country. 
N Of READY. 
Volumes I, II and III, neatly bound in Cloth. Price, $2 50 each. 
‘ It is edited by active, thinking, and liberal men, and published in a style that will 
command the approbation of all critics. The half-year forms a volume replete with instruction, 
and one that is worth much more than the money it costs to every physician.-’—Philadelphia 
Medical and Surgical Reporter, March 5, 1870. 
JAMES CAMPBELL, Publisher, 
Boston, Mass.